travolta
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Post by travolta on Sept 18, 2020 15:55:11 GMT
My daughter had to go into London this morning, hopefully Covid free encounters, came home and put all 'London clothes' in the wash and took a shower, hopefully we are still safe. She worries about us! Eldest is an acute medical care specialist. Come home every night and and showers in the dog bath in his garden. Has spent a lot of time in bad places in the Middle East. Complains continually of his country full of wet willys and malingerers.
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michaelc
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Post by michaelc on Sept 18, 2020 16:13:47 GMT
I think the fact is that until its over* we don't know what will happen next or what the effect of blanket lockdowns was or will be. People who loudly criticised the Swedish "tortoise" long haul approach versus the rest of Europe "hare" approach are quieter at the moment when the Swedish approach seems to be having a more enduring effect (and if they'd looked after care homes better would have had much lower mortality - albeit that's the same in most countries). What has struck me is that, just like with so many issues in the modern era, all we get is polarisation, doubling down on pre-held beliefs and screaming blame games. It's a pandemic and like all pandemics in history it kills millions of (mainly vulnerable) people, one way or another, sooner or later, largely regardless of what you do. *meaning that the virus becomes endemic with seasonal outbreaks I guess that's largely true, although recent counter-examples might include Zika, Ebola and SARS1, which barely run into the hundreds or low thousands. Regarding Sweden's approach, I'd be asking why they've fared SO much worse than their immediate neighbours. As in 12 times the per-capita death rate of Norway, 10 times Finland and 5 times Denmark. I appreciate there's some way to go, but it doesn't exactly look a runaway success. A few weeks ago, Sweden's death rate was "only" 7 times that of Norway. That has now grown to 12 times. What is this "more enduring effect" you refer to? Apologies in advance here if my reply is slightly emotional. The debate most often referenced is the "economic vs covid deaths" discussion. i.e. Lockdown too much and you hurt the economy, too little and too many die too soon from covid19. I would like to point out in stark terms that it is absolutely not just the economy that suffers when you lockdown too aggressively (well it suffers in the end but then you could regard almost any event having an economic event). Ok its not emotional, I've decided against getting too far into my personal circumstances. Suffice to say, when the slider gets pushed too far towards lockdown it has a very significant medical impact on the lives of people close to me - the impact does not just endure during the lockdown it has life changing consequences. Very negative ones. I'm sure there are plenty of other more widespread examples including education and medical treatment postponed. Not to mention "minor" things like teeth pain and abscesses etc. I am not suggesting we push the slider one way or the other - that's for others to judge. But the argument must stop being framed as "only" infections vs economic consequences.
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Post by dan1 on Sept 18, 2020 17:52:01 GMT
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IFISAcava
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Post by IFISAcava on Sept 18, 2020 17:57:25 GMT
I guess that's largely true, although recent counter-examples might include Zika, Ebola and SARS1, which barely run into the hundreds or low thousands. Regarding Sweden's approach, I'd be asking why they've fared SO much worse than their immediate neighbours. As in 12 times the per-capita death rate of Norway, 10 times Finland and 5 times Denmark. I appreciate there's some way to go, but it doesn't exactly look a runaway success. A few weeks ago, Sweden's death rate was "only" 7 times that of Norway. That has now grown to 12 times. What is this "more enduring effect" you refer to? Apologies in advance here if my reply is slightly emotional. The debate most often referenced is the "economic vs covid deaths" discussion. i.e. Lockdown too much and you hurt the economy, too little and too many die too soon from covid19. I would like to point out in stark terms that it is absolutely not just the economy that suffers when you lockdown too aggressively (well it suffers in the end but then you could regard almost any event having an economic event). Ok its not emotional, I've decided against getting too far into my personal circumstances. Suffice to say, when the slider gets pushed too far towards lockdown it has a very significant medical impact on the lives of people close to me - the impact does not just endure during the lockdown it has life changing consequences. Very negative ones. I'm sure there are plenty of other more widespread examples including education and medical treatment postponed. Not to mention "minor" things like teeth pain and abscesses etc. I am not suggesting we push the slider one way or the other - that's for others to judge. But the argument must stop being framed as "only" infections vs economic consequences. nail on head.
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Post by bernythedolt on Sept 18, 2020 18:11:41 GMT
I do not understand the dumb obsession both on this forum and in the media over "deaths"
There is another side to the COVID story, the so-called "long COVID".
By all accounts you may well live to tell the tale of the initial disease. However the mid/long term symptoms go largely unreported and can easily be as debilitating as the disease itself.
"Long COVID" also obviously has the same ability to overwhelm the health services as its elder brother.
That is why you should still take COVID seriously, even if the "deaths" appear to be lower.
When Covid has taken your uncle before his time, as it has mine, come back and tell me "deaths" is a dumb obsession... Consideration of the attrition rate from this thing is hardly a dumb pursuit. It's a good indicator of its severity and whether your nation's policies are getting on top of it. I agree "Long Covid" is a real concern too, so, yes, everyone should be taking this virus seriously.
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IFISAcava
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Post by IFISAcava on Sept 18, 2020 18:29:11 GMT
I do not understand the dumb obsession both on this forum and in the media over "deaths"
There is another side to the COVID story, the so-called "long COVID".
By all accounts you may well live to tell the tale of the initial disease. However the mid/long term symptoms go largely unreported and can easily be as debilitating as the disease itself.
"Long COVID" also obviously has the same ability to overwhelm the health services as its elder brother.
That is why you should still take COVID seriously, even if the "deaths" appear to be lower.
I have quite an interest in post viral syndromes. tl;dr: we are reinventing the wheel. First, whatever is said, the knowledge of what so-called "long covid" actually represents is poor, and filled with anecdotes and uncontrolled studies. Many reported cases of long covid have never had a positive covid test. Second, if it is like the vast majority of other viruses (and whilst we have to have some caution, and need to rule out something specific to SARS-CoV-2, I highly suspect it is), the effects are mostly NOT some direct and specific pathology of the virus, but secondary effects (physiological and psychological) that are reversible with time and treatment. Any severe illness = long recuperation. Third, what makes things worse is fear, anxiety, misinformation, poor advice and hysteria. We are not short of any of those, with the latest I have seen being (inaccurate) reports of permanent heart damage in the vast majority of (highly selected) cases. Yes, a very small fraction of cases may have some severe complications, but people are prone to extrapolate far too much from rare or extreme effects. Fourth, it's rare that a virus is the only thing going on and many of the cases would have (or already had) developed problems from something else affecting the body and/or mind (if you can separate them - which I really don't think you can). Just like many of the deaths were (sadly) deaths waiting to happen in sick, frail and vulnerable people. And lastly, "long covid" (or post-covid fatigue syndrome as I have seen it referred to today) won't overwhelm the health service in the same way that acute COVID-19 could as it is not urgent or life threatening in the vast majority of cases (perhaps suicides being the biggest likely urgent feature). It might however cause plenty of long term sickness absences with all of the social and financial costs of that, and demand for routine health care (i.e. the stuff no one has been doing for 6 months) will escalate. We might even see new health services being developed for 'long covid'. It's also a great source of potential research funds for the "academic-industrial complex" (I made that up btw but you get my point). Postscript: If you want a flavour of where this is likely to be going (and never ending), look up chronic Lyme disease.
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Post by bernythedolt on Sept 18, 2020 19:35:46 GMT
It's a good indicator of its severity and whether your nation's policies are getting on top of it. You ENTIRELY misconstrue the point I was making. I'm not saying the act of dying is dumb. I'm saying the media hounding politicians and experts about "deaths" to the exclusion of "long covid" concerns is dumb. What I'm saying is what you are saying in the above phrase is dumb. "Deaths" alone is not a "good indicator of severity" or "whether your nation's policies are getting on top of it" . "Deaths" PLUS "long covid " is. Otherwise you're just doing a Dominic Cummings .... "oh look Deaths are down, hooray, we've fixed COVID".
Except, of course, that isn't what you said. If you don't express your point properly, you cannot expect to be understood. You accused contributors to this forum of being dumbly obsessed by deaths (in keeping with your usual charming style). I'm intrigued how you might quantify the supposed 'long Covid' debilitations in any meaningful way. Until then, we are stuck with deaths (or excess deaths) as the most informative metric out there. IFISAcava 's 'long Covid' comment above sums it up for me. Dumb BTD signing off...
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Post by Ton ⓉⓞⓃ on Sept 18, 2020 19:38:15 GMT
I do not understand the dumb obsession both on this forum and in the media over "deaths"
There is another side to the COVID story, the so-called "long COVID".
By all accounts you may well live to tell the tale of the initial disease. However the mid/long term symptoms go largely unreported and can easily be as debilitating as the disease itself.
"Long COVID" also obviously has the same ability to overwhelm the health services as its elder brother.
That is why you should still take COVID seriously, even if the "deaths" appear to be lower.
I'm fairly sure I had covid back in April/March, I didn't get tested but the whole of my office, about 6people, went sick in the same week, one tested positive and another had their partner die with it I very sorry to say. I went back to work too soon and suffered leg pains for many weeks afterwards. I don't think I've had "covid toes" but I seem to suffer with a lot of burst blood vessels in my feet (possibly nothing to do with covid). Overall I feel in worse general health now than before I was ill. It's as if covid has artificially aged me an extra 5 or 10years in just a few months. And I don't believe I'm suffering from long-covid.
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Post by bernythedolt on Sept 18, 2020 20:46:32 GMT
I do not understand the dumb obsession both on this forum and in the media over "deaths" There is another side to the COVID story, the so-called "long COVID". By all accounts you may well live to tell the tale of the initial disease. However the mid/long term symptoms go largely unreported and can easily be as debilitating as the disease itself. "Long COVID" also obviously has the same ability to overwhelm the health services as its elder brother. That is why you should still take COVID seriously, even if the "deaths" appear to be lower.
I'm fairly sure I had covid back in April/March, I didn't get tested but the whole of my office, about 6people, went sick in the same week, one tested positive and another had their partner die with it I very sorry to say. I went back to work too soon and suffered leg pains for many weeks afterwards. I don't think I've had "covid toes" but I seem to suffer with a lot of burst blood vessels in my feet (possibly nothing to do with covid). Overall I feel in worse general health now than before I was ill. It's as if covid has artificially aged me an extra 5 or 10years in just a few months. And I don't believe I'm suffering from long-covid.
I hear you and I still wonder if I caught it on our cruise ship back in January, having had a cough that went on for 5 weeks (I've been curious for months and hope to find out next week, having just purchased my home test kit - thanks dan1 ). You may want to consider such a test, now that they are down to a reasonable £39. Blue Horizon was asking £199 for this test two or three months ago. Not meaning to belittle your symptoms in any way, and I obviously don't know whether you, or I, have had it, but I am constantly reminded of the words of the GP who reported that no less than 50% of her patients believed they had been infected by Covid at some point. It's presumably an inescapable part of the human psyche to feel that we, too, are somehow 'special' (and therefore have been afflicted, whether or not it's true).
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Post by bracknellboy on Sept 18, 2020 20:57:52 GMT
My daughter had to go into London this morning, hopefully Covid free encounters, came home and put all 'London clothes' in the wash and took a shower, hopefully we are still safe. She worries about us! I had to do the same thing earlier this week for business. on the plus side it was good to see that where I ended up going for lunch had a reasonable number of clients (outside, sunny weather). Compared to when I travelled through London in July when it was a very scary ghost town. On the downside, I had to remember how the hell to use our company expenses claim system after many months of inactivity. Likewise, I too came through the front door, stripped and showered. I'd like to say that was a prelude to something more interesting, but find myself unable to comment. With the way infection rates are climbing, I'm not expecting to repeat the exercise any time soon.
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Post by bracknellboy on Sept 18, 2020 21:07:39 GMT
....research funds for the "academic-industrial complex" ( I made that up btw but you get my point)..... No you didn't make that up: its existed for decades. You may however have invented a good moniker for it :-) I stand by the challenge I've made before on here: has anyone ever seen any medical or similar research paper that hasn't concluded with those infamous word "..more research/investigaton is required..." kerching
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Post by bernythedolt on Sept 18, 2020 21:15:39 GMT
I guess that's largely true, although recent counter-examples might include Zika, Ebola and SARS1, which barely run into the hundreds or low thousands. Regarding Sweden's approach, I'd be asking why they've fared SO much worse than their immediate neighbours. As in 12 times the per-capita death rate of Norway, 10 times Finland and 5 times Denmark. I appreciate there's some way to go, but it doesn't exactly look a runaway success. A few weeks ago, Sweden's death rate was "only" 7 times that of Norway. That has now grown to 12 times. What is this "more enduring effect" you refer to?That so far Sweden seems to be avoiding the second wave hitting its neighbors (eg new cases in Denmark shooting up and now more than double those in Sweden) and even more the rest of Europe (Spain, France, UK, etc). As I said, they took a tortoise approach of making changes that they felt they could last years not weeks or months. Their death rates were heightened by the way their care homes are set up (eg larger size) versus neighbors like Norway, and by failure to protect care homes sufficiently. And in two years time, after the second, third and fourth waves, we will be better placed to make an informed evaluation of the overall impact of different strategies. It will be interesting after those two years to look back and establish which strategy was optimal. Sweden's difficulty as I see it is this. Based on today's figures, Norway could undergo a further 11 waves equivalent to their first six month wave, yet still remain comfortably below Sweden's deaths per capita. That five year timeline ought to place them comfortably beyond the development timescale for a vaccine, we would hope. Sweden's approach might still turn out superior, time will tell, but I'm not confident.
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Post by dan1 on Sept 18, 2020 21:51:48 GMT
Incidents of acute respiratory infections in care homes are up over 450% in a week (up to 313 incidents) according to the weekly surveillance report. These outbreaks are not necessarily SARS-CoV-2 but include common colds. I believe whether care homes are open to visits from family/friends is patchy depending on the care home and local authority. But, I wonder whether death rates are intrinsically linked to the timing of care home restrictions/lockdowns as distinct from national restrictions/lockdowns. I'd be interested in research around this area. Linking this back to Sweden, it's notable that a country known for not implementing a national lockdown did lockdown their care homes, indeed they will remain locked down until October. It will be informative to see whether they're able to protect their residents the second time around. TBH I was shocked to find their care homes are still in lockdown given the hyperbole surrounding the Sweden question. On this terminology of "lockdown", I argued several months back that there are varying degrees of restrictions (the UK was never in full lockdown just as Sweden wasn't as free a society as prior to CV), and in that vein: And a final note of metrics for comparison. I very much don't trust death statistics published by govts around the globe, it's excess deaths by which we measure pandemics.
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registerme
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Post by registerme on Sept 18, 2020 22:43:04 GMT
but people are prone to extrapolate far too much from rare or extreme effects. I agree with the entirety of your post, but would like to add that the comment I quoted is, to an extent, dependent on trust. Trust that is undermined by a government that excludes its own from its rules, trust that is undermined by vilifying experts only to turn around a couple of years later and say "everything we do is based on our expert advice", and, lastly, that whilst I have little to no problem with the degree of uncertainty exhibited by medics over the last six months, I have very little faith in the general populations' ability to handle uncertainty (and risk / risk mitigation etc) and an unhealthy ability to read into our government commentary ("moonshots" run by Silent L etc).... contempt, for all of us . Right back at the start of this I disagreed with mrclondon. I was wrong. Back at the beginning of this I thought the government was making a reasonable fist of it. Now? Less so. The answer? Education, education, education, education........ iterate until the end of time.
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IFISAcava
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Post by IFISAcava on Sept 19, 2020 8:52:06 GMT
That so far Sweden seems to be avoiding the second wave hitting its neighbors (eg new cases in Denmark shooting up and now more than double those in Sweden) and even more the rest of Europe (Spain, France, UK, etc). As I said, they took a tortoise approach of making changes that they felt they could last years not weeks or months. Their death rates were heightened by the way their care homes are set up (eg larger size) versus neighbors like Norway, and by failure to protect care homes sufficiently. And in two years time, after the second, third and fourth waves, we will be better placed to make an informed evaluation of the overall impact of different strategies. It will be interesting after those two years to look back and establish which strategy was optimal. Sweden's difficulty as I see it is this. Based on today's figures, Norway could undergo a further 11 waves equivalent to their first six month wave, yet still remain comfortably below Sweden's deaths per capita. That five year timeline ought to place them comfortably beyond the development timescale for a vaccine, we would hope. Sweden's approach might still turn out superior, time will tell, but I'm not confident. True - but looking at other Northern European countries, Belgium followed the early (and stricter) lockdown route and had much worse mortality than Sweden AND is having a second wave. At some point there will be some randomness and luck thrown into the mix - not all (or perhaps even most) of the outcome is controllable by local, national or global actions. And I haven't even posted about the epidemiological models that suggest lockdowns actually make things worse in terms of overall viral transmission! But yes - the issue is have the (so far) lower rate countries bought enough time to vaccinate (and keep vaccinating) the population (assuming the population will accept vaccinations, another interesting question that we will find out the answer to in due course).
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