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Thread: Hand sanitiser

  1. #351
    Established TDF Member Doomanic's Avatar
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    My wife was very ill in December with an unidentified virus.
    Quote Originally Posted by Chrisch View Post
    Seriously, forget about sidemount - it's bollocks.

  2. #352
    TDF Member huwporter's Avatar
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    Quote Originally Posted by Wibs View Post
    Interesting Spectator article written by a pathologist, Dr John Lee/
    "How deadly is the coronavirus? It’s still far from clear. There is room for different interpretations of the data"
    https://www.spectator.co.uk/article/...ar-as-we-think

    Interesting points about the wide variation of fatality rates, from the near 10% in Italy to the 0.5% elsewhere such as Germany.
    (Note: this is not having a go at you, it's having a go at the article.)

    In his haste to tell us we should all just go back to work, and sacrifice grandma and a fair proportion of our healthcare workers for the sake of the almighty economy, he completely (possibly deliberately) overlooks the factor of the overwhelming of the healthcare system. The fatality rate is highest in countries (Italy, Spain) that have more critical cases than they have ICU beds + ventilators available.

    Simplified example to illustrate this: Lets say, if you have a critical case of disease X and there is an ICU bed available for you then you have a 10% chance of dying, whereas if you have a critical case of disease X and there is no ICU bed available then you have a 50% chance of dying.

    If your area has 100 ICU beds and 100 cases, then you will see a 10% mortality rate. 100*0.1/100 = 10%
    If your area has 100 ICU beds and 150 cases, then you will see a 23% mortality rate. (100*0.1+50*0.5)/150 = 23%
    If your area has 100 ICU beds and 300 cases, then you will see a 36% mortality rate. (100*0.1+200*0.5)/300 = 36%

    Nobody would even try to argue that the statistics are perfect, they are deeply flawed in many ways. But to ignore/overlook/hide the factor of overwhelming health systems is deeply dishonest. A very major factor in Germany and the UK and other countries seeing low fatality rates as at today is because there are still ICU beds available for the critically ill patients and staff available to treat them. They are several days behind Italy and Spain in growth of new cases - it seems to take 10-15 days for new cases to become critically ill, so the arrival of critically ill cases at hospitals is going to be delayed 10-15 days behind the growth curve of new cases, so expect those fatality rates to start climbing.

    The objective of social distancing, lockdowns etc is to slow down the rate of infection of new cases to reduce the number of simultaneous critical cases following on behind to a point where healthcare professionals don't have to make decisions like "I have 1 ICU bed available and three patients so I am going to try to treat this one person and to leave those two to die in the corridor" or "I've run out of protective equipment so I can either continue to try and save lives at massive personal risk or just walk away and let them die".

    Healthcare workers are literally putting their lives on the line, deepest thanks. Basic respect requires doing what we can to try and help, in this case, rigorous social distancing or (if people are unwilling to comply with that) then lockdowns. Excuse me if I think that neither healthcare workers nor my parents should be avoidably sacrificed for the sake of the share portfolios of the rich.

  3. #353
    rEvo-lution iamyourgasman's Avatar
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    Quote Originally Posted by iain/hsm View Post
    Heck this thread is about hand sanitiser, I came back on to revise my first post.

    No matter. They haven't told you yet, have they. There is no more spare capacity of oxygen in the entire country to drive these additional life support ventilators with. Even the old Oxford Penlon Mark 1's that were modified for hyperbaric use are being dusted off and re greased.
    MDD directive of not we are at a point where the only spare oxygen around is lying in a pool of grease at your local scrap yard or your LDS under the brand of Safe Air Nitrox

    Your rEvo may end up being useful piece of kit after all for a few hours. Just saying.
    We are very acutely aware of this problem. And the old pipeworks in the old hospitals which can’t supply greater flow...COVID19 suddenly unearthed the problems we have been rumbling about and put them in the spotlight. On the other hand there is some amazing response from all parts of the NHS and the public. I hope we can use the next few days to prepare better.

  4. #354
    Cheeky Monkey... Paul Evans's Avatar
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    Quote Originally Posted by Wibs View Post
    Interesting Spectator article written by a pathologist, Dr John Lee/
    "How deadly is the coronavirus? It’s still far from clear. There is room for different interpretations of the data"
    https://www.spectator.co.uk/article/...ar-as-we-think

    Interesting points about the wide variation of fatality rates, from the near 10% in Italy to the 0.5% elsewhere such as Germany.
    Explains it clearly.

    https://news.sky.com/story/coronavir...-rate-11964051

    the actual rate will settle at a couple of %

    In the region of 40 times worse than seasonal Influenza.

    The problem has always been the health services in each country and their lack of capacity during the pandemic. If you dont stamp on it like South Korea and Singapore you get the results Italy are getting

    As Mrs Mouse as pointed out, 2 bases pairs elsewhere in the double helix, as contagious as Covid 19 but as fatal as Mers and we'd be burning bodies in open pits..........And that is only a 10% fatality rate.
    If Ebola goes airborne (Or the next new one) that's the end of the human race as we know it, back to hunter-gathers and the planet would breath a sigh of relief..........

    The thing that boils my piss is the simplicity of all this un-yet there are complete and utter cocks (Let me think) who cant multiply let alone do statistics and cant look at history and learn........
    “Attitude is a choice. Happiness is a choice. Optimism is a choice. Kindness is a choice. Giving is a choice. Respect is a choice. Whatever choice you make makes you. Choose wisely.”
    Roy T. Bennett, The Light in the Heart

  5. #355
    Prior Member Tim Digger's Avatar
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    One thing I think is certain. The analysis of this pandemic, and sadly in some cases the emotional costs will be taking place over the next decade not the next ten weeks. It is far too early to even be sure that the methodology of data collection is robust enough for anything truly meaningful internationally (and that is where it may be possible to compare political and societal responses) to take place. What I am sure is that emotive language and feelings do not aid logical and careful assessment. I have long felt that media treatment of serious studies often aided by shroud waving professionals is very poor. My main criticism is of the concept of "lives saved". We all die sometime and in assessing the success of an intervention we should be looking at how many years of extra life it can provide. Thus a heart transplant on 20, 70 year olds will probably provide a smaller return than 20, on 20 year olds. To use an example about which there is no doubt that demand exceeds supply. The same is becoming true in our current situation. I was making these type of decisions back in the 80's and 90's when we had seriously inadequate ICU provision in part due to political decisions and in part as Intensive Care was just then proving it's worth and place.
    The real pinch point in this whole situation in the UK is the numbers of adequately trained staff to deal with the mechanical ventilators and the patients attached to them. The inadequate recruitment and retention of staff in the NHS over the decades and the hours that have been expected of people in order to provide a financially "efficient" service will bear their bitter fruit. The time to train people to perform dangerous but potentially life extending (not saving) interventions is in advance during the quieter times not in times of crisis. And I believe this will prove to be the biggest failing of the NHS in the weeks to come.
    Evolution is great at solving problems. It's the methods that concern me.
    Tim Digger

  6. #356
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    Quote Originally Posted by Tim Digger View Post
    The real pinch point in this whole situation in the UK is the numbers of adequately trained staff to deal with the mechanical ventilators and the patients attached to them. The inadequate recruitment and retention of staff in the NHS over the decades and the hours that have been expected of people in order to provide a financially "efficient" service will bear their bitter fruit. The time to train people to perform dangerous but potentially life extending (not saving) interventions is in advance during the quieter times not in times of crisis. And I believe this will prove to be the biggest failing of the NHS in the weeks to come.
    That's what our grandson is doing at the moment - working long hours running crash courses to train other NHS in the use of ventilation equipment.

  7. #357
    Cheeky Monkey... Paul Evans's Avatar
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    The Guardian: 'It's a razor's edge we're walking': inside the race to develop a coronavirus vaccine.
    https://www.theguardian.com/world/20...ccine-covid-19

    Great article here.
    “Attitude is a choice. Happiness is a choice. Optimism is a choice. Kindness is a choice. Giving is a choice. Respect is a choice. Whatever choice you make makes you. Choose wisely.”
    Roy T. Bennett, The Light in the Heart

  8. #358
    Established TDF Member Chrisch's Avatar
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    Quote Originally Posted by huwporter View Post
    ...
    Nobody would even try to argue that the statistics are perfect, they are deeply flawed in many ways. ...
    I read the article (have some spare time as it happens..) and agree with your post. Retired old boomer in right wing "magazine" talking right wing shite. But that really was to be expected, these sorts of articles are very much slanted to an agenda (to be fair to the author it may have been heavily edited to that agenda and not reflect his true opinion)

    To be totally fair the discrepancy in outcomes is something that needs more examination. As best I can see there is only one source of empiric data and that is from the outbreak in Italy in Vo' (See https://euobserver.com/coronavirus/147848) This data suggests a volume of asymptomatic carriers of (IIRC) c3%. The success in stopping the outbreak came from extensive testing and containment, this also appears (less reliably) to be the case in some parts of South East Asia.

    The cornerstone of beating the infection therefore would appear to be stopping it spreading by physical containment of both symptomatic and asymptomatic infected people. The current "lock down" policy is attempting to do that. Testing would improve the separation but may or may not be possible on a large enough scale to make a difference. As a non-expert on the medical aspects I cannot say what length of time is needed or how easily the virus transfers - I can only get that information off the news the same as everyone else. I have though worked with data for a long time and it is clear that the extrapolation of the numbers from Vo' into any larger population will give a reasonable estimate of the outcome. Humans are one species and this virus is new so we can assume no existing immunity in (for example) Germany or any geographic area.

    In that respect the article points out that there is an issue and it needs some explanation. Since it is almost impossible that the explanation is clinical it has to be the data collection methodology and definitions. (Again in fairness it does accept that).

    This actually is quite positive in that it suggests the mortality rate is not as high as could be simply because not as many people develop symptoms as feared. Equally this increases the likelihood of spreading the virus if more people are asymptomatic than was previously thought. Ergo I would argue the correct response at this stage until more data and research becomes available is to reduce human movements/contact both in and between distinct geographic areas as much as possible and practical.

    Our government's response is broadly correct if rather too late, Trump and Bolsonaro should now be in the Hague like Saddam Hussein was.

  9. #359
    I still don't have a member
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    Quote Originally Posted by Tim Digger View Post
    The real pinch point in this whole situation in the UK is the numbers of adequately trained staff to deal with the mechanical ventilators and the patients attached to them. The inadequate recruitment and retention of staff in the NHS over the decades and the hours that have been expected of people in order to provide a financially "efficient" service will bear their bitter fruit. The time to train people to perform dangerous but potentially life extending (not saving) interventions is in advance during the quieter times not in times of crisis. And I believe this will prove to be the biggest failing of the NHS in the weeks to come.
    This is very true it is all very well proclaiming we are getting new ventilators and crash course training people. These people are going to be beyond stressed out when they actually have to care for a real live person connected to said ventilator. I am assuming these patients will also have to be anaesthetised something you really cannot learn in a crash course. OH who is expected to go back to work on Monday is still waiting for HR to respond to his email about rejoining the ITU workforce. If he does not have confirmation he is not insured so will not return until he is covered. He will be triaging people so indemnity is crucial.
    A fully paid up member of the CRAFT Club

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    I used to have a handle on life but it broke

  10. #360
    Established TDF Member steelemonkey's Avatar
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    Quote Originally Posted by cazyoung View Post
    This is very true it is all very well proclaiming we are getting new ventilators and crash course training people. These people are going to be beyond stressed out when they actually have to care for a real live person connected to said ventilator. I am assuming these patients will also have to be anaesthetised something you really cannot learn in a crash course. OH who is expected to go back to work on Monday is still waiting for HR to respond to his email about rejoining the ITU workforce. If he does not have confirmation he is not insured so will not return until he is covered. He will be triaging people so indemnity is crucial.
    I would, personally, prefer to be treated by some one like your OH rather than not be treated at all, and hang the paperwork, but I suppose there will always be some jerk who will file a complaint if things aren't to their satisfaction. We must protect those helping us.
    Paul.
    If God had meant us to breathe underwater, he would have given us larger bank balances.
    Human beings were invented by water as a means of moving itself from one place to another.


 
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