Coronavirus Sars-CoV-2/Covid-19 Megathread

[mongers]

The UK government scientific advisor has slipped off message and suggested we could be the worst effected European country. 

Also Johnson leaves hospital.

[celedhring]

Our government offering the opposition to agree on a "reconstruction plan". This sounds so 1940s 

[mongers]

Our government offering the opposition to agree on a "reconstruction plan". This sounds so 1940s 

Yes.

Welcome to the post neo-liberal world.

[Duque de Bragança]

Our government offering the opposition to agree on a "reconstruction plan". This sounds so 1940s 

So that's why Franco was recently dug out?

[Iormlund]

So that's why Franco was recently dug out?

Grave mistake. His curse clearly dwarfs King Tut's.

[Sheilbh]

The UK government scientific advisor has slipped off message and suggested we could be the worst effected European country. 

I think a lot about Chris Whitty being asked about that model that showed the deaths might be under 20,000 given lockdown etc and he said he thought if we kept it under 20,000 "we will have done very well indeed".

Incidentally chatting to researcher friend at a university and ultimately this is ministers' responsibility, but he was saying that most hospitals will have 5 or so PCR machines which can do about 1,000 tests over 3 days. But his university alone has 50, but apparently they're still waiting for Public Health England to authorise them to run tests. He said I think there's only a few universities in the country who have been authorised and it's because they are linked to a hospital already

Our government offering the opposition to agree on a "reconstruction plan". This sounds so 1940s 

Yeah. I think we are looking at something like a post-war rebuilding project for the economy.

[Tamas]

If it turns out the unis can't start testing because tests are being made by some business link to members of the government, I won't be surprised one bit. I mean, Priti Patel is arguably the second most powerful minister and she was busted selling her governmental services to private business so bluntly it would even make Orban blush.

[Threviel]

Sweden 12, Denmark 13. Sign of things to come.

[Sheilbh]

If it turns out the unis can't start testing because tests are being made by some business link to members of the government, I won't be surprised one bit. I mean, Priti Patel is arguably the second most powerful minister and she was busted selling her governmental services to private business so bluntly it would even make Orban blush.

What's the Patel story? (Not that I need another reason to think she's unfit for high office )

From what my friend was saying it's not to do with the tests - it's that they're just not being authorised by PHE to run the tests presumably because they don't have the appropriate sign-off/paperwork. Which I feel someone should be saying doesn't matter during a pandemic, the universities need to be allowed to help and if they're not necessarily certified we can work around that.

From what I read on the tests the NHS and PHE apparently buy all their tests from very few suppliers - which is fine in normal times because they can buy in bulk and have a huge amount of leverage on price. But that's a problem when they want to ramp up testing because they don't have existing contracts with other suppliers (who will probably be prioritising their existing customers). NHS procurement is infamously byzantine because again - for decades our focus has been maximising efficiency and, across government, we would rather have a considerably worse service than the slightest chance that someone's getting something they shouldn't (see also DfID and the DWP). I hope that focus shifts a bit after this.

I also think a lot about the comparison with Germany where you have truly Federal health responsibilities. Scotland, Wales and Northern Ireland have control over health and public health. But NHS England has had a lot of reforms over the last 30 years that are very focused on reducing inefficiency and, in theory, improving care by introducing basically an internal market so there's accountability. Also the idea was to basically "remove the politics" from the NHS which sounds great, but actually means the elected political people at the top can't really do old style command and control because the leadership is actually this sort of technocratic, semi-independent bodies like NHS England, Public Health England, each of the NHS Trusts etc who all have their own budgets and autonomy. Part of me feels like we got all of the costs of a fragmented "apolitical" system without the benefits.

Edit: Incidentally, just because I think there's lots of coverage about people breaking the rule - we've had very nice weather this Easter weekend and very broad compliance. I'm not sure if there is an actual shift in the numbers, but this is the sort of messaging I think is helpful at this time - emphasise the people following the rules, not enforcing against the small number who aren't:

Britons stay at home under lockdown despite Easter sunshine
Police report deserted beaches and parks as public largely follow instructions and avoid travel
Mark Brown
Sun 12 Apr 2020 16.47 BST
Last modified on Sun 12 Apr 2020 16.57 BST

A number of police forces have reported that the public are following instructions to stay at home and avoid travelling far, despite the temptations of warm Easter weather across Britain.

Devon and Cornwall police posted a series of photographs of beautiful and deserted beaches that would usually be crowded in such good weather.

Richmond Park, which a fortnight ago was attracting crowds of people on a sunny Sunday, was largely empty on both Saturday and Sunday, judging by photographs posted by local police.

Surrey police also posted "a huge thank-you to everyone in Surrey who has listened and is following government advice this bank holiday weekend to #StayHome despite the good weather".

There were photographs of near-empty beaches in seaside resorts including Scarborough and Brighton, with people clearly staying away despite the sunshine.

On Saturday, Sussex police tweeted: "Thanks to everyone who has again today played their part in helping us save lives. In the main, beaches, parks, beauty spots and green spaces are quieter. Even the seagulls are social distancing, though we strongly suspect they are missing people and their chips."

The Peak District national park stayed "largely quiet" on Saturday, according to officials, and photographs posted on social media suggested the same on Sunday.

It was a similar situation at Victoria Park in east London, which reopened on Saturday after a controversial two-week closure. Local Bow West police tweeted a photograph of the park with few people in it: "Patrols around #VictoriaPark today. Lovely to see people #SocialDistancing."

The UK health secretary, Matt Hancock, on Sunday thanked the public for "rising to the challenge".

Data from a health app that asks users about their movements also suggested that people were taking social distancing measures more seriously than before. The Evergreen Life app said it had data based on almost 75,000 responses about how its users were responding to government advice.

In Middlesbrough, which last weekend was the area on the app where people appeared to be flouting the stay-at-home rules, the number of respondents who admitted they were not complying dropped from 25% to 13%.

Non-compliance with social distancing also fell in Hertfordshire, from 18% to 9%, and in Burnley, from 18% to 14%.

Evergreen Life's chief executive officer, Stephen Critchlow, said: "We can see that Evergreen Life users, who get regular nudges to remind them of the benefits of staying at home, are generally following government guidelines, and those that were not have improved dramatically."

[Iormlund]

From my experience validating safety critical components, it is almost impossible to deviate from the standard protocols unless there are contingency plans already in place (which requires forward planning) or there's written permission from someone high up in the food chain (which requires someone to stick his or her neck out).

[Sheilbh]

Two slightly grim sides of this, the FT have published the NHS's "tool" for triaging patients:


Clinical judgement is still key but this is used to provide a structure for the decisions by doctors. They emphasise it's just a tool/outline but if there's someone who's over 80s but in good nick they're not going to necessarily follow this. They asked doctors if this was about lack of resource, best medical treatment or if they're likely to make it. Apparently their view is it's a bit of all three. Because there's no cure people don't go to ICU to get treated, they go to ICU because they might need/will get more aggressive organ support and ventilation so they can fight off the virus. So part of it is just about assessing who is most able to fight this off and what's the benefit to an individual who is likely to be able to fight it off to spending their last days intubated etc. It is a bit callous - but doctors are, they're all psychopaths as far as I can see - but I always kind of admire medics for really thinking about the ethics of this and how to make the worst decisions.

Linked to this is GPs, carers and hospices are requesting for a relaxation on the "Shipman rules" for palliative drugs (like muscle relaxants and morphine). Since Dr Shipman there have been strict rules on the use of those drugs, but apparently people who are dealing with end of life care (before covid 19 hit the patient) are saying it's just not working at the minute because covid 19 can worsen very quickly and pharmacies are already overstretched, which makes getting the palliative drugs more difficult. They want to go back to the pre-Shipman rules temporarily where they can administer the drugs and fill in the paperwork retrospectively. The fear is that there are basically patients who are suffering more than they should while they wait for relief/palliative drugs.

FT gave the story of a man who was in his 60s, on a six month prognosis with lung cancer and was now receiving end of life care. He contracted covid 19 and was doing okay one morning, but was in severe difficulty a few hours later and from the carer's point of view clearly only had a few hours. Because of the issues above it took them a while to get the drugs they needed, but they eventually did and he had his final few hours on morphine and muscle relaxants so in far less severe pain/discomfort.

[Josquius]

Patel truly is showing herself to be the right wing Diane Abbot.
If Diane Abbot was on meth.
And evil incarnate.

[Sheilbh]

I love Diane Abbott tho!

[Tamas]

I just meant her Israel trip, Sheilbh.

[Admiral Yi]

Sweden 12, Denmark 13. Sign of things to come.

Doesn't Norway get to play?