Coronavirus Sars-CoV-2/Covid-19 Megathread

[Sheilbh]

Hancock said that much, indeed.

I am sorry Sheilbh but 600 people per day are dying with a thousand hospital admissions per day and we are still trying to get the measuring stick out in the park to make sure we don't over-inconvenience people for a couple of weeks?

Yes - although obviously there's a lag. Two weeks ago we didn't have lockdown we had guidance and unfortunately we had to have lockdown because people weren't following the guidance.

We might need to get stricter, but last week Patrick Vallance said the early academic evidence was that the infection rate was below 1 which is the goal. Every briefing in the last few days has included data showing very widespread compliance. If that evidence has changed and there's now indications the infection rate is above 1 again, or there's data showing widespread flouting of the rules then I think there's a good case to get stricter on this. But if there's not then all I'm seeing is lots of conflicting anecdotes, Piers Morgan retweeting photos of people in parks and calling them "traitors" (I bet he has a garden) and a bit of a media furore. I have no issue with the government tightening rules if there's a good reason based on scientific advice and evidence, I have a problem if it's mainly because the media have got over-excited/are desperate for a story - especially because the impact will be disproportionately felt by working class and poor people, not, say, Piers Morgan.

I also think it's unlikely this'll be over in a couple of weeks. We're looking at 2-3 months. Lots of people don't have outdoor space, especially in cities. And I think everything we are doing should be on the basis that it needs to be sustainable for several months.

My own experience - and that from my friends who were in different parks over the weekend is nothing like the pictures we saw a fortnight ago. There's a bit of London bashing in this, but from everything I've seen there's very little evidence that Londoners aren't behaving very sensibly and doing as asked.

Edit: And I think this will probably go on - on and off - for possibly a year or more (I hope I'm wrong). For what it's worth on my walk yesterday the biggest risk factor was small kids (also there's something really adorable but very sad in seeing kids of like 4-5 with face masks on) who are struggling with the concept of social distancing/not playing with each other though their parents are trying their best from what I saw

[Duque de Bragança]

This somewhat optimist article is for Savonarola though there no details on signaling and high-speed use: 

https://www.france24.com/en/20200405-france-marshals-high-speed-trains-to-transfer-coronavirus-patients

The high-speed train whooshing past historic World War I battle sites and through the chateau-speckled Loire Valley carries a delicate cargo: 20 critically ill COVID-19 patients and the breathing machines helping keep them alive.


The TGV-turned-mobile-intensive-care-unit is just one piece of France's nationwide mobilization of trains, helicopters, jets and even a warship, deployed to relieve congested hospitals and shuffle hundreds of patients and medical personnel in and out of coronavirus hotspots.

"We are at war," President Emmanuel Macron tells his compatriots, again and again.

But as the 42-year-old leader casts himself as a warrior and harnesses the might of the armed forces, critics charge that he waited far too long to act against this foe. France, one of the world's wealthiest countries with one of the best health care systems, they say, should never have found itself so deep in crisis.

Macron had just emerged from weeks of damaging retirement strikes and a year of violent "yellow vest" protests over economic injustice when the pandemic hit. Now he is struggling to keep the house running in one of the world's hardest-hit countries.

The Rungis food market south of Paris, Europe's biggest, is transforming into a morgue as France's death count races past 7,500. Nearly 7,000 patients are in intensive care, pushing French hospitals to their limit and beyond. Doctors are rationing painkillers and re-using masks.

France's centralized state and powerful presidency make it easier to coordinate the exceptional patient-moving efforts, which have crisscrossed the country and even extended to overseas territories.

But the pandemic has exposed weaknesses in the world-renowned state hospital system after decades of cost cuts. When the president visited a Paris hospital on the front lines of the virus battle, an angry neurologist challenged him to reinvest massively.

'Hospitals going up in smoke as fast as Notre Dame'

"When it was about saving Notre Dame, many were moved," Dr. Francois Salachas said, a reference to the Paris cathedral that was severely damaged by fire a year ago, prompting immediate, massive pledges of public and private funds for reconstruction. "This time it's about saving public hospitals, which are going up in smoke at the same speed as Notre Dame almost did.

Many think Macron did not anticipate the severity with which the virus could hit and set a bad personal example. Similar criticisms have been leveled at other world leaders including the presidents of Mexico, Brazil and the United States.

In February, Macron made a point of repeatedly kissing Italy's premier on a visit to Naples to show there was nothing to fear. At the time the virus was already spreading fast across France, but limited testing meant health authorities didn't yet know.

In early March, he toured a retirement home even as he announced that families should no longer visit elderly relatives. That same day he went with his wife to a Paris theater where the owner tweeted that the president wanted to show that "life goes on." By then the official virus infection numbers in France were doubling every two days.

In mid-March, as COVID-19 was ravaging neighboring Italy, France went ahead with the first round of nationwide municipal elections. First lady Brigitte Macron strolled the banks of the Seine, which were crowded with Parisians enjoying a sunny day despite recommendations of social distancing.

'We are at war'

It wasn't until March 16 that Macron abruptly changed his tune, declaring war on the virus and announcing nationwide confinement measures. A week later he appeared wearing a face mask for the first time at a field hospital set up by troops outside Mulhouse, the eastern city that saw an eruption of cases stemming from a five-day evangelical gathering.

The armed forces took on a key role, as military and hospital authorities worked out the system to shuttle patients to less-strained hospitals and medics to virus zones in need.

The first "medicalized" TGV made its inaugural trip on March 26. Doctors in protective gear pushed gurneys along the nearly empty platform of the train station in the eastern city of Strasbourg as safety warnings echoed from loudspeakers. Inside the double-decker cars, patients and webs of tubes and wires were squeezed past luggage racks and rows of seats. Once they were secured, the train sped off toward less impacted hospitals in the west.

While the militarized mobilizations are broadly popular, public debate mushroomed over issues such as the relatively low numbers of people being tested for the virus in France and shortages of medical equipment. Macron ordered all face masks requisitioned for medical personnel after it became evident France entered the crisis well short of the necessary supply.

'Masks are a priority question for France'

"The question of masks is now the priority question for the French," said Jean-Daniel Levy of polling agency Harris Interactive, adding that the public feels the government "didn't take enough responsibility" for it at the outset.

France has had to send some patients for treatment to neighboring Germany, which has conducted massive nationwide testing and confirmed more cases than France while recording a death toll about one-fifth as high so far.

Macron, a centrist, has taken fire from both ends of the political spectrum.

Far-right leader Marine Le Pen told France 2 television that "the government lied about the preparedness of the country," while far-left leader Jean-Luc Melenchon said Macron, a former investment banker, "used to think that the free market would meet the country's needs, so his mental framework collapsed."

Among the broader public, Macron "is seen as relatively authoritarian," Levy said. That hurt him during the protest movements but helps his popularity now because "we want to have a strong authority figure" to manage the crisis.

In the National Assembly, the lower house of parliament, a fact-finding mission is scrutinizing the government's handling of the emergency.

Macron, however, said while visiting a mask manufacturing company that it's not yet time to focus on what went wrong.

"When we're fighting a battle, we must all be united to win it," the president said. "And I think those who seek to send people to trial when we have not yet won the war are irresponsible."

[Maladict]

Lowest number of hospital admissions in two weeks, sharp decline over the last three days. Could it be? 

[Josquius]

I also think it's unlikely this'll be over in a couple of weeks. We're looking at 2-3 months. Lots of people don't have outdoor space, especially in cities. And I think everything we are doing should be on the basis that it needs to be sustainable for several months.

My own experience - and that from my friends who were in different parks over the weekend is nothing like the pictures we saw a fortnight ago. There's a bit of London bashing in this, but from everything I've seen there's very little evidence that Londoners aren't behaving very sensibly and doing as asked.

Edit: And I think this will probably go on - on and off - for possibly a year or more (I hope I'm wrong). For what it's worth on my walk yesterday the biggest risk factor was small kids (also there's something really adorable but very sad in seeing kids of like 4-5 with face masks on) who are struggling with the concept of social distancing/not playing with each other though their parents are trying their best from what I saw

The lack of a garden in my flat is the biggest reason I'm keen to get my house move done ASAP really. It'll be so nice to be able to pop outside whenever with no fear of running into any of my elderly neighbours.

I can't see the current situation going on for too long. Easter stands out as a huge event in the calendar, if nothing changes or shows signs of changing after that then I really expect an uptick in people disregarding the rules.

A return to even partial normalcy is some way off but I can very well see things slackening somewhat in the weeks to come, even if its very much region by region. Privacy intruding phone tracking would be really useful right now.

[Sheilbh]

Scandal in Scotland as the Scottish Chief Medical Officer has admitted that she's travelled to her second home in Fife both of the last weekends (against her own social distancing guidelines). She's been appearing on adverts in Scotland telling people to stay home.

Police Scotland have issued a statement condemning her behaviour and said officers have visited her to issue her with a formal warning.

At the minute the Scottish government are backing her. It seems like it could be a really tough issue because on the one hand they presumably really need her advice at the minute, on the other hand she's broke her own rules (and, I don't know about Scotland but in England this would be breaking the law too) which will undermine public support for the rules (one law for us another for them etc).

[Sheilbh]

UK numbers are out, up to over 12,000 antigen tests (I think this count doesn't include tests of healthcare workers) which is a start towards 25,000 antigen tests and 100,000 tests of all types.

Obviously that's limited but about 6,000 new cases or an increase of 15%.

621 deaths which is also ano increase of about 15%. As with celed, probably worth waiting until Tuesday to see what happens but hopefully we can peak at around those numbers. Also might get hospitalisation numbers at the government briefing later today but so far the news on that has been good. It seems like yesterday's numbers on regional breakdown of fatalities may have been a blip as London is back up to 174 (which is also around 15%, I think - but regional stats here are a bit of a mess/confusing). But Midlands back down to 74, North-East and Yorkshire just over 100.

[celedhring]

Spanish gov is outlining its post-lockdown plans. It will involve having enough PCR testing capacity to test anybody showing mild symptoms, doing massive cribbage of contacts/community with quick tests, and isolating positives in specially designated buildings (not hospitals). They will also begin a serological study to ascertain the % of Spanish population that's contracted the illness.

They have also hinted that masks will be mandatory once enough supply is secured.

Sounds good, if they are capable of developing those capabilities.

[mongers]

Lowest number of hospital admissions in two weeks, sharp decline over the last three days. Could it be? 

I wonder if the surprisingly dry and now warmer weather is playing a part?

If so it might be a bit of a Easter miracle, though it doesn't save any hospital staff fighting in confined environment, where they also face a heavy virus load, which does seem to be playing a role in killing perfectly health young doctors and nurses.

[Josquius]

I thought the thing was dry weather is good for the disease and we needed rain to knock the dust in their air down and flush it out?

[Sheilbh]

Yeah I thought it was warm and humid weather that might have an effect? 

[PDH]

It is apparently warm and humid air, and warm and dry air.  Oh, and cold and humid air, and cold and dry air as well that is conducive to the virus spreading.

[merithyn]

You guys understand that the issue with 3000 people going to a park over the course of a day isn't just about how far apart they are, yes? 3000 people bringing germs to whatever the touch is deadly. The chances that no one touched anything while they were at the park is slim to none.

[Sheilbh]

Sure - but there's a cost/benefit to this. Over the course of a day in 50 hectares - with 3,000 people (some exercising - which the government recommends people do, or relaxing - which is probably against the rules) there will be some people leaving traces through contact. I think personally that's probably quite low risk - for example I went to a park for about an hour yesterday and didn't really touch anything except through walking - sat on a tree stump for a while which is about it.

So I think you have to balance the benefit of eliminating that risk against the cost of people not being able to get out - a family in a small flat in a tower block, for example - in my borough I think there's estimated to be between a quarter and a third of the population in low quality or overcrowded housing (it's only about a year ago that landlords had an obligation to ensure their properties were "fit for human habitation"). That presents real health risks for people, both physical and mental health. If I thought this was just for a few weeks I'd be a bit more sanguine, but I think this will last for months and (on-and-off) possibly a year or more, so one more push of being really strict won't eliminate this, it's going to be a long-term thing. And the alternative is people will still go out for exercising (as recommended) they'll just all be in streets, which are narrower and also have people doing other essential journeys such as shopping for food or collecting prescriptions.

That's why, I think, at the minute the UK guidance is parks should be open. Sometimes they will get a little busier than ideal in London because we're a crowded city, where most people don't have any outdoor space and we've been explicitly told - don't leave the city because we're a hotspot.

As I say if there's evidence that the infection rate is tracking up, or that people are flouting the rules on a widespread basis then fine we may need to go further. But we're not there yet. Hancock in his statement said no change is imminent because the vast majority of people are following and not trying to bend or break the rules, which is good.

There was a technical issue at the briefing today. But on hospitalisations it has shot back up in London, the Midlands, the North East & Yorkshire and the North-West. London still looks below where it was trending which is good, Midlands appears to be reverting to trend, the two Northern regions looks a little more worrying. According to BBC Health Correspondent expectation in England is that we will peak next week, but it's not as clear how long it'll last (sounds like we'll plateau like France, Italy and Spain). Apparently admissions so far are at the lower end of what they were predicting/expecting/modelling which is good-ish news:

Also hospitalisation rate appears to have been fairly consistent across the week (it was 9,000 on Monday and is around 16,500 now - so probably about a week to double), hopefully this rate will start to decline next week.

[Gups]

Brockwell Park is open again tomorrow.

[Tamas]

Watford general hospital almost ran out of oxygen yesterday had to tell people to stop going there and started to draw up plans how to prioritise who gets oxygen and who (likely) dies.

Also this: https://www.theguardian.com/world/video/2020/apr/05/on-our-knees-nhs-nurse-pleads-with-public-to-stay-indoors-video#comments

But god forbid people can't go to parks!