[Richard]

The need for enforced quarantine rules being clarified has now been clarified, one of those in the two week huddle from the first lot has been threatening to abscond possibly violently. If he puts that into practice, I guess he would earn himself a criminal record as an instant bonus under the new rules, perhaps with added points for any act of violence. Downside, he would no longer be able to work overseas in most countries as a result, we would be stuck with him.

I will explore the option of Mg.

[Ed P]

On the news it was reported that they talked him out of his threat last Thursday so the Government did not have a real trigger except a realisation that the term voluntary quarantine meant just that, and maybe they needed a few teeth.

That said it would be interesting to learn just how the authorities manage the logistics of self quarantine. I know for example that we would be pretty much out of food after four days, and if children were included they would be driving any parent up the wall within that period.

[The VFM Addict]

What the British government will do if coronavirus spreads.      Its worth a read.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Ed P]

The WHO says that tracing contacts is a vital part of slowing the spread of the disease, but I saw no mention of that in the Telegraph blurb. I guess the realisation has kicked in that there is apparently little you can do when someone without apparent symptoms can spread the disease by touching surfaces with their hands.

Imo that is wrong-headed. The Government should be thinking of free issue of a basic alcohol hand gel and encourage people to use it if they touch anything in a public place. They should also consider mask issue to every home in the same manner as Singapore. If we cannot import enough, we should be investigating ways of manufacturing them ourselves. Without that measure we will be unable to force people to wear masks in public places, but I guess our surveillance mad society would hate anonymous people walking around the streets.

[Ed P]

Interesting but worrying  stats in this Ars report on the cruise ship moored off japan.

They have reportedly tested just 439 people, and of these 30% have tested positive. Pretty poor odds if you get in contact with someone with the flu.

The worrying bit comes that even a sophisticated country like Japan jibes at testing 3000 people. I wonder how many people we can screen in the UK?

[Richard]

As I read, possibly the same reports, the passengers on the ship were being tested if they had symptoms, or if they were close contacts of sick persons. On that basis a high hit rate should be expected. All passengers have been issued with thermometers and other items such as masks. I understood that temperatures have to be taken according to a regular schedule with verification of the result. Those managing the ship are limiting interactions and potential transmission in either direction.

Perhaps we read differently, but tracking symptomless people and their contacts is a difficult task even for some such as the SS or Stasi who tried in the past. I am seeing substantial reports of contact tracing, requested self quarantining and numerous closures of locations as a result.

With a population of 70 million, face mask issuing would require approximately 210 million masks to be found, packed and delivered to? That is based on wear one wash one change into one. Hand sanitiser would require lesser numbers. However, I have frequently attended hospitals complete with my admission form in hand. Every time that I am one of the less than 60% to bother. (I complete mine on the computer, meaning that it can also be read, another unusual feature.)

Prudent and to my mind sensible steps are being planned, including the compulsory quarantine when needed. Based on my previous experience of communicable illness investigations, contact tracing was pursued with some vigour, though not always with complete success. It is also hugely labour-intensive with interviews that took time. Few people remember the sources of possible infectious contacts, even when the problem in question has a short period between contact and illness.

[Ed P]

As a minimum our Government should have put out a did you sit near Steve Walsh between January 28th and ?? February as soon as it became obvious that he is a superspreader.

 

[Richard]

There we have a couple of centres of issues, naming a suspect (Wot abat GDPR, et-al) and more challengingly, how many times have you ever known the name of a passenger with whom you travelled? It is some years since I travelled apart from a few trips to and from central London on fruitless trips to evaluate my wife’s suitability for medical trials. The only person with whom I know I travelled was my wife, though several passengers did appear not to be of UK origin. We only inferred this, as they said they were going to the airport to go home.

[Ed P]

If you looked at the link you will see a fairly good photograph of the gentleman. I have a lot of admiration for the way that he has publicised his own details.The Government could have asked him to do this weeks ago. They could also have added the main places he visited and mode of travel. His pub has been covered as has his workplace, but I’m certain that there are others.

Quite frankly I’m disgusted that this Government treats us like mushrooms (keep in dark and cover with BS) rather than as adults. The Government’s main objective has too obviously been  to buy time for themselves and to prevent panic, They have failed to grasp the nettle while it was very small.

[The VFM Addict]

I’m not sure that issuing masks and gels will be enough.    It is now known that this virus hangs around in the air after an infected person sneezes or coughs such that you can be infected even after that spreader has left.    Eyes are as vulnerable as the mouth and nose.   Hence there is a need for goggles also.   Perhaps this is why it still exploded in China even after masks were being used and hand hygiene practiced.  Very few civilians wore goggles.   Once it gets full blown here my outside wear will be hoodie, goggles and FFP3 mask.    With one set rotating with another and sanitization between uses.    Currently I’m just using a standard disposable non-valved mask of which I have 100 and I may still have a local retail source for more in 50 batches; although I’m not sure how long that will last despite them buying-in 1,000’s.   They might already have run out as I’ve not spoke with them for a couple of days.

Returning to the Diamond Princess ship again we must remember lag-time between infection and symptoms; during which the evidence inclines to the conclusion that one is still contagious.    That incubation period possibly varies up to 42 days it now seems.   This might possibly be due to some folk’s immune systems fighting but slowing losing a holding action.   The problem is that if one waits for symptoms to show before testing one can never catch-up because by then others have been infected and are already starting their incubation periods.   And so it goes on.

What particularly concerns me is that unlike most of the coronavirus family it seems this one is not slowed by high temperatures and humidity.  So the end of ‘the flu season’ will not give us a respite.    In Hong Kong of 19 who attended a BBQ party 9 were subsequently found to be infected (47% WOW).    This virus is damned infectious.

The MRC Unit at Imperial College London have completed modelling and calculate the likely CFR (death rate per infection) to be 1%.   Note – That is per infection and not only 1% of those who are hospitalised.   That’s will be around 670,000 deaths in the UK.   To put that into perspective flu usually kills 600 a year in the UK on average and never more than 10,000 even in the worst of years in the modern era; and we know that even such, by comparison small numbers are enough to overwhelm our NHS.   I do not think Imperial College looked at anything more than those killed specifically by the virus.   But I would imagine many will additionally die of other causes simply because the NHS is to overloaded to treat those as well as normally.

Crazy as it is there is some logic in saying that the Sussex Super-Spreader won the Survival Lottery Jackpot.   He has recovered and now has immunity.   Perhaps it is better to get this virus early while you’ll still get intensive care from the NHS if you need it and before the ITU’s are mega swamped with 3 mile queues outside every A&E in the land.

Some experts now suggest that this virus cannot be stopped until the world has a vaccine or an anti-viral with >60% effectiveness.    But the chances are that by the time they are available almost everyone will have had it and have either died of have survived it and have personal immunity anyway due to such.

The bad news for us Forumites, given that most of us are lads and are of the older generations, is that so far world-wide it seems 80% of those who do die are over 60 years old and 75% of that vulnerable subset are male.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[The VFM Addict]

Breaking New this bugger now has a name – ‘Covid-19’.    Can’t help but wonder if the covert nature of this virus given that it can spread pre-symptoms influenced that choice.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Richard]

There is a difference between the now recovered gentleman allowing his image to go out and him being plastered on what might appear to be wanted posters. It was only recently that the police were castigated for distributing warning notice telling a town’s shopkeepers to watch out for a persistent thief. Apparently, that contravened the human wrongs act. Still, if anyone remembers seeing him at the relevant times, then they do now have the option of identifying themselves. However, I would not recognise anyone I saw in a shop even the day after. I might watch out for any symptoms, knowing that some perceived threat might have been abroad. It is called taking personal responsibility.

If you want comforting fairy tales, then the option is yours to write them. I have heard quite enough information and can combine that with years of experience to know that a balance has to be kept. I am currently unable to find any trace that I am in the dark about these issues though I have a strong desire to base feelings on clear evidence for any necessary actions. There is evidence that the Chinese model has let China and the world down badly.

[Ed P]

The odds skyrocket against you if you are a smoker. That actually may support the apparently  low (1% CFR) that ICL calculated as most male Chinese are smokers and help explain why death rates outside China appear much lower. This is not due to Chinese medical facilities being worse than the west, generally they are just as good. Different, and probably overwhelmed but just as good.

As an anecdote to support that assertion an American colleague was involved in a very nasty but all too common road accident in Urumqi and had to be treated on the spot.  When he eventually was able to be medivaced back to the States he of course had all his many inserts and sutures checked over by US surgeons. The opinion was that they equalled the best practice in the US except that stainless steel was used, whereas the US practice was to use titanium.

[Ed P]

The CFR wiki is worth a look. It puts the death rate in context 10 to 20 times worse than ordinary flu but 30 times better than H5N1 flu. (the bird flu that has been on the edge of becoming infectious for some years).

[Richard]

Covid-19, is now the official name for the virus, since it has no species, racial, ethnicity, religious, country or location relationship.

It has now been tested for 1,358 times in the UK with 8 results being found positive. This suggests nothing more than it is too early to assess either infection rates or the readiness of the medical testers to arrange testing. Two labs have now been set up in Scotland, they were using English testing facilities so there is an expansion of available test facilities.

Racism incidents have already been noted as increasing and not just in playgrounds, with some high-profile characters falling into the traps associated with ill-judged commenting.

[The VFM Addict]

The smoking issue will logically negatively affect survival rates s it does with an pneumonia.   However, I suspect the difference is not such as to explain the difference between 1% of confirmed cases outside China but the 18% that is now being postulated for within China.   Certainly there is a difference but not such a severe one in other pneumonias.

I suspect death rates will increase outside China as state’s health services become increasingly overwhelmed and are unable to any longer provide optimal supportive care for most of the infected.    As my earlier post probably implied my gut feeling is that a 1% death rate in the UK will be highly unlikely especially once one includes incidental deaths due to overload.    Heaven knows our NHS overloads even in heavy normal flu seasons with operations needing to be put off.    One’s chances of getting optimal supportive care if you need it will surely fall as the number increase to the point of it being extremely unlikely you’ll get it.   Then it will pretty much be solely the ability of one’s own immune system to win the war without back-up which decides one’s chances of surviving.

One thing I should have added re one’s own PPE is that if one has any cuts on one’s hands the virus can enter easily before one gets to washing one’s hands.   Therefore disposable rubber gloves possibly two of the thin ones on each hand surely become essential to add to masks and goggles.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Richard]

Medical facilities in other parts of the world are often looked down on by visitors and outsiders. I broke my leg in the Middle East in an office accident, later one or two medicos here, knew the orthopaedic surgeons out there, one had trained some of them. Their verdict was, ‘I am glad they attended you and I did not have to, that was a mess’. It took time, but I could walk and run once more.

Japan appeared premium, but the style was unfamiliar territory. Doctors were gods and nurses were god’s right hand people. As a foreigner I was treated differentially as a parent in a children’s hospital ITU.  When I suctioned our premature infant daughter ready for a feed, nurses watched but Japanese parents withdrew when feeding cleaning, changing or anything else was due. Medical staff did it all for their child. Entry to the ITU, required washing changing, suiting and booting through several changes.

In both locations I found  the main difference was the ease of access to medical treatment compared to here. I suspect that patient health and lifestyle will be a critical factor. Those whose habits such as smoking and other environmental aspects may be adversely affected. The same may well be found here, where life outcomes tend to reflect personal lifestyles. The unfortunate business man who brought Covid-19 back from Singapore says he has completely recovered, is this result of his lifestyle or the normal run of these things?

[Richard]

Some districts of China are now clamping down on self medication with typical treatments such as ibuprofen, Aspirin and several others being blocked to force people to go to hospital. That sounds a bit tough on those with other ailments.

[The VFM Addict]

The evidence is that 82% of people will handle this virus little differently from normal flu.  So for many what happened with the Super-Spreader would be the norm relatively rapid recovery without drama.    However, 15% get it severely but are never critical.   To what extend their passage to critical was thwarted by medical intervention or what that intervention was I do not know.   The other 3% do progress to critical.    Some survive some don’t but clearly that is often with good supportive care.

What is of great concern is that of those currently diagnosed very few have recovered yet; far less than 10%.  This is not to say those who have not yet recovered will die.    But, and here comes the rub, they are clearly taking up beds.    So even were the death rate of those hospitalised in the UK to be low but recovery protracted, that only makes overload of the NHS even more likely.    It is as if this virus has studied military doctrine and is following the practice that a wounded enemy who needs far more than simple first aid places far more drain on the enemy’s resources than killing that individual instantly.     This virus is far more than anything like a highly dangerous but nonetheless short lived 5 day flu.   The stats suggest it is more like on average a highly dangerous 3 to 4 week flu before recovery is typically likely to be achieved.    The resource drain of even those who in the main survive will be fatal to the NHS’s capacity to deal with anything else.    A full week’s wait for an ambulance perhaps?   By which time the matter will already be settled one way or the other and either no ambulance or a hearse will be required.   Bring out your dead !!!

As regards self-meds while Aspirin and Ibuprofen might be of use, Paracetamol, is by far the best for dealing with high temperatures.    Perhaps not a bad idea to stock up on all now.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Bob Williams]

This is a good point VFM:

” It is as if this virus has studied military doctrine and is following the practice that a wounded enemy who needs far more than simple first aid places far more drain on the enemy’s resources than killing that individual instantly. ”

My analogy would be regarding active service and using a weapon against an enemy during my time in the army (’64 to ’76). It was said at the time, quite erroneously, that the British Army was taught “shoot to kill”. That was wrong and I suspect, still is. Disregarding the very small percentage of us snipers, soldiers were taught generally to aim for the centre of the body. The reasoning was that one wounded enemy required 5 or more personnel involved in removing the wounded soldier from the battlefield, carrying out casevac and treatment. All of which uses resources. Our weapon at the time was the 7.62 SLR and one strike anywhere on the body, from that high velocity round would usually incapacitate the target. This disease does appear to follow a similar course.

The relatively high number of cases in China, is due IMO to the high density of population. 1.5 billion is a lot of people and when one considers that Wuhan is just one Chinese city, yet larger than London, it puts a perspective upon the problem. SE Asia has many countries with a high population density, I believe that this disease has only just begun to become serious there. This is the world picture to date:

http://tinyurl.com/s6woz8q

Probably out of date. although dated today, cases by country:    http://tinyurl.com/ub9gvyc

World’s largest nation by area is the Russian Federation, China’s neighbour with a large and mostly porous border. Just two cases, if Vladimir Putin is telling it like it is. The RF has a population of almost 146 million:     http://tinyurl.com/yfny3pes

Only the cities have any real population density and at this time of the year the weather is not conducive to large gatherings.

My fear is that one infected person, or a carrier, attends a football match at one of the large English stadiums. Or any stadium really.

When the Thought Police arrive at your door, think -
I'm out.

[Author]

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