Hancock's Half Hour

[doctor Bob]

My sister is a diagnostic radiopgrapher, she works on a breast screening unit, Stopped and moved to the front line.
Reckons there were 18 radiographers fighting to do an xray due boredom.
She says it was like having one bus and 18 drivers.

 

[Chris152]

I read today that, based on studies in Spain, the evidence suggests that "herd immunity" is a non-starter as only 5% of those who had recovered from Covid had developed antibodies, the remaining 95% being susceptible to re-infection.
To quote The Lancet on this subject:
"In light of these findings, any proposed approach to achieve herd immunity through natural infection is not only highly unethical, but also unachievable."
Pete

Pete - this is how the BBC is reporting that study:

'The study of more than 60,000 people estimates that around just 5% of the Spanish population has developed antibodies, the medical journal the Lancet reported.
Herd immunity is achieved when enough people become infected with a virus to stop its spread.
Around 70% to 90% of a population needs to be immune to protect the uninfected ...
"Despite the high impact of Covid-19 in Spain, prevalence estimates remain low and are clearly insufficient to provide herd immunity," the study's authors said in the report.'
https://www.bbc.co.uk/news/world-europe-53315983

So if I'm reading it right, it's not 5% of those who have had the virus and recovered but 5% of the total population. The latest i've heard in the Uk is that between 5 and 8% of us have or have had the virus, so maybe it's similar in Spain? 5-8% seems to equate to about 60 000 deaths in the UK, which makes achieving 70-90% of the population with antibodies without a vaccine an ethical problem for the herd immunity solution, I'd think.

 

[RogerS]

I read today that, based on studies in Spain, the evidence suggests that "herd immunity" is a non-starter as only 5% of those who had recovered from Covid had developed antibodies, the remaining 95% being susceptible to re-infection.
To quote The Lancet on this subject:
"In light of these findings, any proposed approach to achieve herd immunity through natural infection is not only highly unethical, but also unachievable."
Pete

Pete - this is how the BBC is reporting that study:

'The study of more than 60,000 people estimates that around just 5% of the Spanish population has developed antibodies, the medical journal the Lancet reported.
Herd immunity is achieved when enough people become infected with a virus to stop its spread.
Around 70% to 90% of a population needs to be immune to protect the uninfected ...
"Despite the high impact of Covid-19 in Spain, prevalence estimates remain low and are clearly insufficient to provide herd immunity," the study's authors said in the report.'
https://www.bbc.co.uk/news/world-europe-53315983

So if I'm reading it right, it's not 5% of those who have had the virus and recovered but 5% of the total population. The latest i've heard in the Uk is that between 5 and 8% of us have or have had the virus, so maybe it's similar in Spain? 5-8% seems to equate to about 60 000 deaths in the UK, which makes achieving 70-90% of the population with antibodies without a vaccine an ethical problem for the herd immunity solution, I'd think.

A very good point, Chris. I'll emphasise it for those who are hard of understanding. To achieve 'herd immunity' implies many extra 100,000's of deaths.. That's OK according to Rorscharch since 85% of deaths are in the over-65's and we don't count any more.

 

[Chris152]

Very easy to have the caring attitude for instant death (days and weeks) and forget about the long term deaths over the next few years. Seems selfish and unthought through.

I think the problem is, either way (serious lockdown or no lockdown) we're going to continue to suffer heavily. (We seem to be almost at the 'back-to-normal' stage in the UK.)
If we fail to lock down efficiently the virus seems set to continue spreading and killing - the early estimates of 500 000 sounds about right to me given the death rate we've experienced for % population infected. Which I'd think would lead anyway to a situation in which little in the NHS functions properly for rather a long time, and clearly the economy won't be functioning properly either as families are hit repeatedly by deaths and much of the nation descends into a state of gloom, despair and fear.
If we stay in significant lockdown, the economy continues to be seriously damaged with all the negative consequences on our health etc that would follow. But at least we can wait to see what vaccine/ therapeutic treatments are developed, if any.
I think there's a naive optimism and arrogance that most of us share as human beings - that somehow we can control everything. The reality is we're stuck between a rock and a hard place. But it does seem to me holding the virus at bay while we wait for solutions is the best way to go.

 

[Rorschach]

My sister is a diagnostic radiopgrapher, she works on a breast screening unit, Stopped and moved to the front line.
Reckons there were 18 radiographers fighting to do an xray due boredom.
She says it was like having one bus and 18 drivers.

Anecdotally I can confirm a similar situation. The family member I have mentioned before had their cancer treatment delayed by 12 weeks, this despite the fact the South West has seen very few cases and our local hospital was like a ghost town. Before the OP they needed to have a CT scan, they weren't given an appointment, they were asked when they would like it as the schedule was open, they were the only person on the list to have a CT scan that week!
The staff went in on a Sunday to do the scan, I think it was a team of 2 or 3 people who ran the machine, they went in, did the scan, cleaned up and went home again as they no more work that week :shock:

 

[Rorschach]

A very good point, Chris. I'll emphasise it for those who are hard of understanding. To achieve 'herd immunity' implies many extra 100,000's of deaths.. That's OK according to Rorscharch since 85% of deaths are in the over-65's and we don't count any more.

I didn't say it was OK, I said it was inevitable, big difference. I'd love it if we lived in a world where no one got sick and no one died, but that isn't reality.

 

[doctor Bob]

Very easy to have the caring attitude for instant death (days and weeks) and forget about the long term deaths over the next few years. Seems selfish and unthought through.

I think the problem is, either way (serious lockdown or no lockdown) we're going to continue to suffer heavily. (We seem to be almost at the 'back-to-normal' stage in the UK.)
If we fail to lock down efficiently the virus seems set to continue spreading and killing - the early estimates of 500 000 sounds about right to me given the death rate we've experienced for % population infected. Which I'd think would lead anyway to a situation in which little in the NHS functions properly for rather a long time, and clearly the economy won't be functioning properly either as families are hit repeatedly by deaths and much of the nation descends into a state of gloom, despair and fear.
If we stay in significant lockdown, the economy continues to be seriously damaged with all the negative consequences on our health etc that would follow. But at least we can wait to see what vaccine/ therapeutic treatments are developed, if any.
I think there's a naive optimism and arrogance that most of us share as human beings - that somehow we can control everything. The reality is we're stuck between a rock and a hard place. But it does seem to me holding the virus at bay while we wait for solutions is the best way to go.

Thank you, a calm response, appreciated.
I have a picture in my head of some posters on here, red in the face shouting at the laptop, working out how to get one upmanship in insults. I liked Mr Grimsdale he had a great mind and a lot of banter, he never got shouty, his assets were the abnility to get people frothing at the mouth without him (rarely) losing his cool. Much more reasoned debate with him. It really is no point in having debates discussions with shouty angry people who just accuse people of being thick or hard of understanding, as all that implies is they believe there opinion is better and you are to stupid to understand why they are right. Then you get the ones who send you PM's, just odd behaviour.

 

[Phil Pascoe]

Mr Grimsdale he had a great mind and a lot of banter, he never got shouty, his assets were the ability to get people frothing at the mouth without him (rarely) losing his cool. Much more reasoned debate with him ...

I think you and I are thinking of a different Mr. Grimsdale. :?

 

[selectortone]

I'm sorry, but I have no idea what "indirect farming" might be. Do you mean importing food? But everyone is on lockdown - supply chains are failing. I was reading today about seed potatoes being thrown away, because there is no market: every kilogram of seed potatoes = 20kg or more of produce in the shop after harvest, and many, many tons of seed potatoes are being destroyed. Mountains of meat has been thrown away (animals killed and buried), because the system is broken.

That report related to US states like Idaho that supply potatoes for hundreds of thousands of fast food restaurants, which have been shut during lockdown. The same applies to the meat referred to. I know you love a good panic, but the system isn't broken, supply chains are not failing.

 

[Woody2Shoes]

My sister is a diagnostic radiopgrapher, she works on a breast screening unit, Stopped and moved to the front line.
Reckons there were 18 radiographers fighting to do an xray due boredom.
She says it was like having one bus and 18 drivers.

The great difficulty is that the 'new normal' for cancer screening and treatment - and all other medical diagnostics/treatments, including dentistry for example - now has to be 'covid-safe' to avoid the situation where lots of healthy, productive, young(ish) healthcare professionals fall sick (and recover/die/suffer-long-term-after-effects) as has been the case in the UK/Italy/Spain/elsewhere.

A medic who could see/treat ten people a day will perhaps only be able to "safely" see/treat five people a day (and probably at a greater PPE cost than previously). The economics/productivity of healthcare provision has now been altered by Covid.

If you look at the contract tracers there's probably 1000 drivers for every bus at the moment!

 

[Woody2Shoes]

I'm sorry, but I have no idea what "indirect farming" might be. Do you mean importing food? But everyone is on lockdown - supply chains are failing. I was reading today about seed potatoes being thrown away, because there is no market: every kilogram of seed potatoes = 20kg or more of produce in the shop after harvest, and many, many tons of seed potatoes are being destroyed. Mountains of meat has been thrown away (animals killed and buried), because the system is broken.

That report related to US states like Idaho that supply potatoes for hundreds of thousands of fast food restaurants, which have been shut during lockdown. The same applies to the meat referred to. I know you love a good panic, but the system isn't broken, supply chains are not failing.

I think it's fair to say that our food production systems were broken long before Covid came along!

 

[ScaredyCat]

As a side note, when did we move from "There's a 1 in 4 chance that someone you know will get cancer" to "You have a 1 in 2 chance of getting cancer"?

I noticed this on an advert for donations last night.

.

 

[Rorschach]

As a side note, when did we move from "There's a 1 in 4 chance that someone you know will get cancer" to "You have a 1 in 2 chance of getting cancer"?

I noticed this on an advert for donations last night.

.

If you live long enough you are almost certain to get cancer of some form, I am struggling to find the story I read now but all men will get prostate cancer eventually, but usually they die of something else before it becomes an issue.
So I guess as we are living longer they are changing their adverts to reflect this.


As a side note of my own, I just heard on the BBC news headlines that for the second week in a row now nationwide deaths are below the 5 year average, hmmmm now I wonder who said that would happen :wink:

 

[Lons]

As was Britains cancer crisis on BBC1, lots of young and middle age people losing their lives and savings. Theropies stopped mid way through, one lady spending £250k to have private treatment stopped by NHS. The effects and deaths will be considerable.
Difficult balancing act, but it seems like cancer care just stopped, so I suppose it wasn't a balance at all.
For me with parents who are 87, I know they have had a wonderful life and I will be devastated when they die, but would I (I know they wouldn't) put them before a young woman with 3 kids and potentially years of forefilling life ahead of them, NO.
Very easy to have the caring attitude for instant death (days and weeks) and forget about the long term deaths over the next few years. Seems selfish and unthought through.
Please (general broadcast) don't start frothing at the mouth, it gets people no where and just stops me responding, also I will not respond to pointy finger accusations, be rational and nice :lol:

Certainly won't be me Bob, the only time I get red faced is during strenuous exercise and no froth gets near my mouth unless it's on top of a fashionable coffee. :lol:

I agree with much of the above, remember that despite being accused of wanting to protect life at all cost that is not what I meant or believe. There are very different balancing acts and nothing is ever black and white. I just have an opposite view to yours regarding lockdown in that I think it should have been sooner, and very firm then perhaps we might have come out of it quicker as well. There is little doubt it was handled badly, information was sketchy and confusing along with the usual political digs from all sides that always happen however no matter which political party was in office the outcome would just as likely have been chaotic.

I do think that comparing your parents with a young woman and 3 kids is a red herring as unless you were to stand them together and say "either you or you is going to die now" and you can't do that. :roll: Perhaps if the woman had terminal cancer but if so she's going to die anyway and if she was treated in hospital at the height of the pandemic then she would quite possibly be infected while there and die. That happened to the mums of 3 of my friends btw.
Would you stand in front of your parents and say you have to die so my business can thrive? Maybe you would but I seriously doubt it, I couldn't as I would find a way to survive hard times but not the guilt of killing my parents. Is that analogy any more silly than yours?

People screaming about loss of income to protect the old and that the country will be in debt for generations have been happy enough to contribute to that debt by claiming free £10k / 25k handouts, rate holidays, grants, interest free loans whilst still being allowed in many cases to work and earn, I consider that to be hypocritical, had I still been in business I'd have taken them as well just wouldn't have screamed about the consequences. The old they are protecting, many living hand to mouth on a poverty line state pension got nothing from the state apart from the extremely vulnerable in receipt of a weekly food parcel, They are not shouting they're just happy to be alive as is their right after a lifetime of work and contribution to the economy. Caring is what is supposed to make us human but inevitably the greed and self preservation traits surface for all to see.

As far as staff being seconded to the front line and underused, again not a black and white argument as in some areas including parts of the north east they were much busier than that and very close at times to being at the limit. I have family working in Newcastle RVI who took the first 2 C19 patients in the UK so I also get info first hand.
Not all cancer and other treatments were cancelled either, at least not in my area though most were and not all appointments cancelled by the NHS, many were cancelled by patients themselves who were scared of catching the virus while in hospital. My wife was one of those though not a cancer sufferer and they were right to be worried as the nature of their illness makes them vulnerable whatever their age. Same applies to referrals as people were scared to go to the doc but that's a different argument and some blame can be directed at media hysteria.

I also have family working in various medical capacities in other N.E. hospitals, a niece who's a GP in Cheltenham and another a specialist nurse in a London hospital so am hearing very different stories to yours.
There's no easy answer and we all look at it differently and are influenced by our own circumstances but whatever happens going forward is going to be a mess for all of us.

Good to see that you at least, unlike others are astute enough to look at other income avenues going forward, hope the mutt project is successful.

 

[Terry - Somerset]

I think herd immunity is the only answer - the issue is how do we get there:

- let it rip, quick solution, NHS overwhelmed, morally very very questionable
- vaccine, not available yet, if/when it will be "engineered" herd immunity
- permanent lockdown measures - no herd created and not sustainable
- accept moderate level of transmission/death, moderate return to "normality"

The minimum size of the herd depends on the rate of transmission. For CV-19 this was about 2.5 in the UK. To hold the number of infected people in a community stable requires 60% of the population to be infected. Changes in behaviours (eg: distancing) may reduce this to 2 .0 or less if sustained. Note that measles is far more infectious and would require ~90% immunity!

Problem is that we do not have all the answers to make an informed choice.

The most vulnerable may already have been infected so mortality will be reduced in the future. Virus may have mutated to the point that it is no longer as dangerous - if a virus kills its host then the virus dies with them!

Vaccine may be available within six months, or maybe never.

Treatments to minimise the impact of CV-19 are emerging but it is not clear how much more improvement can be expected. As an aside - AIDS was originally a death sentence, it is now (mostly) treatable with an appropriate drugs regime.

Strict lockdown will not stop the virus but it would be economically very costly and need to be in place almost indefinitely - years or even decades. Unworkable in any other than a police state or dictatorship.

So we are by default effectively following a middle path of accepting some fatalities whilst trying to re-open the economy. Behaviours have changed somewhat so the rate of transmission may be somewhat lower than its "natural" state in the UK. For now this seems a reasonable strategy until the unknowns can e nailed down.

 

[doctor Bob]

As far as staff being seconded to the front line and underused, again not a black and white argument as in some areas including parts of the north east they were much busier than that and very close at times to being at the limit. I have family working in Newcastle RVI who took the first 2 C19 patients in the UK so I also get info first hand.

My sister lives in Bradford ..............

 

[Droogs]

I do have to say that this missed cancer treatment problem seems to have been due to decisions made by the NHS Trusts or government in England as up here in the far North, my chemo started the day after lockdown and has continued all the way through. Infact I have my last radiotherapy session tomorrow afternoon . During this whole time the cancer unit has been working at full normal capacity and has cancelled no treatment.

So bear in mind if people have been let down south of the border, then it is due to bad management and not the need of the NHS system

 

[doctor Bob]

Infact I have my last radiotherapy session tomorrow afternoon . During this whole time the cancer unit has been working at full normal capacity and has cancelled no treatment.

Good to hear and wish you all the best.

 

[Rorschach]

I do have to say that this missed cancer treatment problem seems to have been due to decisions made by the NHS Trusts or government in England as up here in the far North, my chemo started the day after lockdown and has continued all the way through. Infact I have my last radiotherapy session tomorrow afternoon . During this whole time the cancer unit has been working at full normal capacity and has cancelled no treatment.

So bear in mind if people have been let down south of the border, then it is due to bad management and not the need of the NHS system

Some good news. Hope everything has been successful!

 

[Trainee neophyte]

I'm sorry, but I have no idea what "indirect farming" might be. Do you mean importing food? But everyone is on lockdown - supply chains are failing. I was reading today about seed potatoes being thrown away, because there is no market: every kilogram of seed potatoes = 20kg or more of produce in the shop after harvest, and many, many tons of seed potatoes are being destroyed. Mountains of meat has been thrown away (animals killed and buried), because the system is broken.

That report related to US states like Idaho that supply potatoes for hundreds of thousands of fast food restaurants, which have been shut during lockdown. The same applies to the meat referred to. I know you love a good panic, but the system won't broken, supply chains are not failing.

A funny thing about food: consumers don't buy it as a discretionary purchase, only as and when they are feeling flush. Food is eaten daily, by almost everyone, all the time. If they don't buy their potatoes at a restaurant, what will they eat instead? If less food is grown for domestic consumption in the USA, will they all go on much-needed diets, or will they Import from elsewhere, once a shortage becomes apparent? Also remember that food can't be turned on and off, like a factory production plant: cull your herd, and it can take years to get production levels back up.

I am expecting food price increases over the next year, but not in anything I produce, unfortunately. This will hit the poorest countries hardest, as always. Don't forget that a quarter of the world's pigs were culled in China, locusts are running riot across Africa and into the far east, and China has yet another crop crisis with the armyworm.

If you tot up the damage caused by biological factors in China over the last couple of years, you might think someone was out to get them.