[Ed P]

Hand hygiene to cut down covid-19 transmission.

A US friend of mine sent me the following:

. . . : 1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc. 2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove. 3) Open doors with your closed fist or hip – do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors. 4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts. 5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been. 6) Keep a bottle of sanitizer available at each of your home’s entrances. AND in your car for use after getting gas or touching other contaminated objects when you can’t immediately wash your hands. 7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more! What I have stocked in preparation for the pandemic spread to the US: 1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas. Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average – everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon.”

He assumes that the Covid-19 virus is not aerosoled – jury is out on that, but it is true that sneezing is not a symptom of Covid-19 infection. There are some reasonable strategies in his notes, but latex gloves may be more of a pain than a value, as not only do you have a disposing problem, getting them off without contaminating your hands is close to impossible!

[Ed P]

Looks like @vfm is correct, the US CDC recommends that health professionals wear eye protection link

It is however a bit of cause and effect as new patients are subjected to treatments that will probably cause the generation of virus-carrying aerosols.

(Note the CURRENTLY do not recommend the public wear N95 equipment)

[The VFM Addict]

I’m still a bit concerned about the statement that sneezing is not a symptom of Covid-19.   Some reports say it has been seen.   However, even if it turns out to be 100% correct that Covid-19 never causes sneezing, a very real danger exists that Joe Public will misinterpret that message as meaning that sneezing is evidence that an individual does not have Covid-19.   That is highly dangerous.

Covid-19 infected individuals might sneeze due to many other causes and when they do they will spray out infected droplets no matter what caused the sneeze.    For example, colds can co-exist with Covid-19; for some moving into bright sunlight can provoke sneezing; some people suffer perennial allergic rhinitis while as the weather warms our old friend seasonal allergic rhinitis (hay fever) will be with us.   Indeed while hay fever in the UK is mainly caused by grass pollen about 25% of sufferers are equally susceptible to birch tree pollen and that peaks in April and May which will be right in the middle of the main Covid-19 surge.   I believe one must assume that all sneezes are potentially virus laden.

In summary – I believe it is important to always stress that while sneezing is not in anyway diagnostic of Covid-19 sneezing does not mean that an individual does not have Covid-19; and if they are infected and sneeze it will be just as infectious no matter what caused it.

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My other half has a sales and marketing background as do I but hers not as deeply routed in para-medical marketing.   When working she always excelled at thinking outside the box and coming up with strategies that were highly effective.   Chatting last night she said she wondered if HMG had remembered the power of ‘the Soaps’ for spreading messages and provoking public symmetry.   It hadn’t even occurred to me but of course she was absolutely right.   The principle of ‘product placement’ used often in the USA works equally well with ‘message placement’.    If people hear or see folks doing things in Corrie, Enders and Emmerdale then many will copy that lead. Once seen on those shows things become the norm for huge swathes of folk many of whom pay far less attention to other message platforms.   Folks in the Soaps should immediately be seen washing their hands constantly, avoiding handshakes and opening doors in an aseptic way, etc.   It will provoke such habits in certain sectors of the population far more effectively than would a large HMG advertising campaign.

Appropriate advisory email sent off this morning to various officials.

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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]

Felt like screaming and tearing my hair out as I read this on the BBC news feed regarding Italy.

Half of all confirmed coronavirus patients in the country have mild conditions and have been told to stay at home, according to Italian news agency Ansa

Some 40% are in hospital and only 10% are in intensive care, Ansa reported.

What idiot wrote that?   ONLY, yes ONLY 10% of the infected need Intensive Care.    So if only a tiny 3% of the UK get infected (that’s 2Million) then all we will need will be only 200,000 ICU beds.    That’s alright then, isn’t it.    Hang on.   We only currently have 167,000 beds of all kinds in the NHS let alone ICU beds.    I think we might just have a sight problem perhaps?     Oh silly me I’m being so foolishly distrusting.   After all Boris and Matt Hancock have both said our NHS is prepared.   So I guess that the NHS have 200,000 ICU beds tucked a way in a cupboard somewhere ready for a rainy day along with a life sized terracotta army of medically trained robots to service them.   Nothing to worry about folks, move along 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.

[Ed P]

I’m afraid that the BBC is no longer to be trusted, it is just a Government mouthpiece. Their consistent message has been in effect, stop worrying about it and do nothing that will damage the economy.

I think if you want to stir things up, a letter to the Daily Mail or Express might be more effective than anything else. However other than stir it up, it would not really help the situation. The population needs a measure of fear, but it would be counter-productive to scare the pants off everyone.

My concern from the outset has been that the mass psychology of the populace has been mishandled from the start. Concern should have been built slowly and the public slowly educated into better habits (I certainly go along with your wife’s strategy of using ‘soaps’.) Instead it was a policy of lies.

I think the Government should have put aside their concerns over surveillance and encouraged the wearing of masks. Even cotton ones would reduce onward transmission of viruses to a degree. The whole strategy should have been to run measures to slow the spread in parallel with the WHO containment strategy.

Although the Government message on hand-washing is correct, it is totally impractical in most situations and people realise this. (Where do you wash your hands in public places?). Better more practical advice should have been given e.g. if alcohol gel is not available, use Dettol wipes (they claim effectiveness) or similar to clean your hands after touching things that others may have touched. Keep wipe in a plastic bag that you carry with you, and bin when you get home.

Unfortunately we have a Government where their housemaids/cooks do all the work, so they have no idea of practical constraints or issues.

 

[The VFM Addict]

HMG are saying that around 20% of the UK workforce could be sick at one time when this peaks.  OK lets work rationally with that figure.

There are approx. 26.5 million people employed in the UK plus approx. 4.5 million self-employed people.   That’s a UK workforce of 31 million.    So if 20% of that workforce are sick at one time that’s 6.2 million simultaneously ill during the peak.    Let’s be optimistic and say only 3% of those deteriorate to needing an ICU bed and intensive care in order to ever pull through.    That means we will need at the epidemic’s peak 186,000 ICU beds (i.e. 3% of the 6.2 million simultaneously ill) plus heaven knows how many non-critical beds we would needed in addition trying to support the very unwell patients so that they don’t ever progress to being critical.

Hang on though.   20% of the UK’s 31 million workforce isn’t 20% of the UK’s 67 million population, is it?    Presumably at the peak there will not be merely workers who are ill?   So we will need far more than just the 186K ICU beds for workers who are critical.   One hell of a lot more because we will need beds the very old younger infirm (all non-workers) and a group most likely to deteriorate to the point of needing Intensive Care.

Note everyone reading this that the above is based squarely and solely on HMG’s own explicit statement that 20% of workers will be simultaneously ill at the epidemic’s peak.    Only a fool would fail to see that there will be no care available for the vast majority who need it at the peak.   Stark as it is to face, the only rationale personal strategy is to take every possible precaution imaginable to avoid getting infected or at least avoid getting infected until the peak has long passed.

I personally believe that huge inconvenience and a battering of one’s personal finances in preparing for this are far more preferable to the alternative.  That alternative for most of us here being very grim due to age and to already existing medical conditions.   The NHS will not be able to afford to try to save those in whom the chances of success are far from optimal.    Nor would I want them to.   If it’s a young mother with kids or me that gets the only available ICU bed and ventilator I agree it should go to her.   Realistically the chances of that resource having been well spent if spent on her must be far greater than if spent on an old phart like me.    Besides if I get this virus then my other half will and her chances of surviving it are well below zero.   So I’d have no body who was heavily dependent on me being around if I caught this whereas a young mother would.

I started this thread on 23 January and quickly recogning where this was quite likely to be heading I’ve had time to come to terms with it; to consider the best strategies and to prepare for it by gathering what is needed to enact them.   I truly believe that in doing so I am not just looking after number one (and number 2, SWMBO) but doing my part in looking after everyone else.   Because if I can avoid getting infected then I am one less potential ‘spreader’ and one less person placing a burden on the NHS at a time when its resources will be depleted in the extreme.    I have tried in this thread to provide to Forumites the information which HMG and the MSM had withheld or been hesitant to disclose; and to encourage others to take the maximum possible steps to protect themselves and in doing so protect others and NHS resources.    I believe, Ed, has reached a similar conclusion.   I, and I expect Ed also, would welcome the company of all other Forumites in this endeavour.

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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]

As said before — if an old phart — we are doomed! Best do a Howard Hughes.

Retire from public life and rent a cottage on the Isle of Man. (£100/night seems to be the going rate), I guess a discount for a one year rent so say £25000 as an insurance policy if you are quick!

The cheapest, but slightly risky, option might be to locate a covid-19 hotspot and catch the virus while UK health care still exists.

Of course you could still just play the odds,  Only 80% will catch the virus, and of these only 50% or so of our age group will be critical  so there is a two thirds chance of not needing to do anything!

[The Duke]

If this does turn out bad, alot of small businesses will go to the wall, just through bad information and panic.

If the pub was to have to close  for 2 to 3 weeks, it would put the place in a huge whole.

Doesnt even need to close, just people staying home could be as bad. Not to mention this week is the start of the holiday season. If people stop coming to their vans, it’s gonna be bad for local businesses.

[JayCeeDee]

The VFM Addict wrote:

HMG are saying that around 20% of the UK workforce could be sick at one time when this peaks.  OK lets work rationally with that figure.

Not a critical riposte, just a cautionary one – it is vital to read the wording of some of the statements quoting numbers that are coming out and “translating” them. I’ve seen some statements today about the predicted percentages of people off work; that number was not split into those too ill to work, those who are well enough to be out in the public domain, but cannot get to work due to lack of public transport, or those that have self-isolated. I bless sub-titles, because when you see the wording, rather than hearing it, you add a level of adjustment to the figures – sometimes we hear what we expect to hear, rather than what has been said.

[The VFM Addict]

Ed, can’t say I didn’t half seriously consider the catch it early strategy.    Were I alone I might just have opted for it.   But with my other half being reliant on me she would have been up the river without a paddle while I was would have been playing Emo quite possibly for a time on ECMO.

At 80% coverage one is without extensive precautions highly likely to catch it,  If we do at our age  its close to a coin toss whether one goes critical and if so a about half again that one ends up as involuntary charcoal     That is one cascade of possibilities I’d rather not play Russian roulette with.   At least in RR if you get unlucky you never know about it.    Viral pneumonia is not a nice process although you have normally been put in a medically induced coma during the latter stages to reduce your body’s oxygen requirement and increase you odds of pulling through just a fraction. Been there, watched it, albeit with with bacterial pneumonia of a relative and it ‘taint nice.    And don’t forget if one does nothing and catches it one numbers take off one can pretty much assume that if you go critical you’re a goner ‘cos getting an ICU bed will be remote in the extreme.    So I think I’ll stick with a strategy which reduces the chances of having to play gamble of the century while the epidemic is in full flow.

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Fatality rates are likely to be in Europe closer to those in Italy rather than the 1% seen in China outside Wuhan.   The WHO believe the level of care and use of ECMO in China far exceeds that which is and will be available elsewhere in the world.   ECMO is basically a heart and lung machine that takes over most of our body’s respiratory functions until our lungs can recover.   We have only 6 centres in the UK with such machines to cover the whole country.   So ECMO will play virtually no part in reducing fatalities in the UK whereas it has played a major part in China.

Bruce Aylward of the WHO Team that visited China –

“The average case fatality rate is 3.8 percent in China, but a lot of that is driven by the early epidemic in Wuhan where numbers were higher.  If you look outside of Hubei province [where Wuhan is], the case fatality rate is just under 1 percent now. I would not quote that as the number. That’s the mortality in China — and they find cases fast, get them isolated, in treatment, and supported early. Second thing they do is ventilate dozens in the average hospital; they use extracorporeal membrane oxygenation [removing blood from a person’s body and oxygenating their red blood cells] when ventilation doesn’t work. This is sophisticated health care. They have a survival rate for this disease I would not extrapolate to the rest of the world. What you’ve seen in Italy and Iran is that a lot of people are dying.”

I’ve been concerned up but truly never spooked until now.    A 2% case fatality rate in the UK which is below that which Italy is experiencing and assuming that infection peaks at just 66% of the UK population rather than the 80% some experts are suggesting would see 900,000 deaths here.   So, for Matt Hancock to say that 500,000 deaths is a reasonable worst case scenario if anything is still to substantially down play what is more than easily possible.

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Duke, I’d be inclined to tout your place as the safest place to eat and drink while Covid-19 is around.    I’d do that by having a bouncer on the door with one of those temperature scanners and a sanitizer hand gel that patrons must use before entering.    BTW I’m not joking.

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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]

I agree Steve, and that in a small but personal way is why HMG is down playing the risk, and another reason why HMG should be making you wear a cloth mask to “make your place ‘safe’ for the public”. The greater the emphasis on supposedly safe places, the more likely the public will continue to use them.

Although I am annoyed with HMG for not using people who could have advised on mass psychology, I do understand their overall strategy even if I think their tactics stink. We need to keep the country running as normally as possible even if this means that BoJo and the Beeb lies even more than usual.

Our own family strategy is to spend a modest amount on insurance  — A smallish 14 day store cupboard of non-perishable foods (the Brexit backup), N95 masks and filters in case this area becomes a hot-spot , gel (actually IPA spray), Dettol wipes (sod trying to wash hands in the Tesco car park), zinc pills, and 24 chloroquine tabs to tide us through while awaiting any covid-19 test results. Other than the chloroquine tabs that is also how we have advised our adult children.

We will still holiday this year, probably around Oxford and walk the canal tow-paths/rivers between pubs. We will however skip foreign holidays as I suspect saving Brits will be bottom of any European objectives. Other than that we will take our chances (two to one on is not too outrageous) and not spend the kid’s inheritance by renting a cottage in the IoM!

[edit] catching up on your post , the Italians say that their high CFR is due to demography, like the Japanese they have a very elderly population.

[Ed P]

One lie I fully expect to be promulgated by HMG is ‘It will all be OK if we can contain things until the Summer’. (That of course ignores that 28C is considered cold in Singapore, and Senegal isn’t exactly cool!) So when you hear the lie, just nod wisely knowing why it is told.🤔

[Richard]

The hand wash idea has certainly not got through to most of the population as yet, Even when there are facilities available, i.e. when the punters need to dodge past the sink, soap and tap, about 60% of people using ‘the facilities’ did not bother to wash their hands, most of them then went on to buy food and drink. How many will pay any head to the idea of hand sanitising is anyone’s guess, mine is that it will be a small number. My wife has dug out the spray she was given as part of one of her ‘welcome packs’ during her treatments. It appears small enough to be discrete and easy to use, but will clearly not last for ever.

To be fair I have heard, seen and read the message about hand washing, fronts, backs between the fingers and across the nails and take at least 20 seconds, almost to the point of being able to remake a COI film.

I am not so sure that banning football matches would obtain enough ‘leverage’. However, religious gatherings have been effective infection promoters. Just look at Korea and Iran.

Residential facilities, commercial and personal residences, are a risk just see how many became infected. Any restrictions need to be proportionate and carefully targetted

To a large extent Covid-19 needs to be promoted as an optional illness. Unless people take inter-personal responsibility the issue will become far bigger as the careless fall prey and spread the risks to others.

The issue of face masks has been extensively discussed and yes for outbound bugs they may be effective, sadly less so for the inbound variety and then only if well-designed, manufactured and maintained (with binning frequently the only maintenance for some types). I guess full face motorcycle helmets might well provide substantial protection against inbound infections, protecting the face and blocking all hand contact as a bonus. I do not propose to adopt that solution.

However, infected people should not need to bother too much with masks; they should be keeping/kept out of circulation. Italy has shown how hospitals and old persons’ homes are likely to be death camps – infected older persons are probably the reason for the Italian death rates.

Both my wife and fall into a number of undesirable risk camps, age, co morbidities, etc. so we are not unaware of being close to, if not in the firing line. Our task is to keep our  heads down and minimise the risks we can control, while trying to retain some normality. Most supplies are already delivered rather than fetched, though I am uncertain of the risk profile of visiting supermarkets. It falls to everyone to minimise their risks.

I am aware that it is likely to be a bad time for of Steve. Sadly, I can offer no suggestion or aid for the many thousands of ‘Steves’ who will also be affected. Some government assistance is promised/threatened but it is unclear to me how much relief that will provide to affected small businesses.

[Ed P]

I’m not sure that Singapore has been using ECMO for the populace although their healthcare is good that sort of facility would only be found in the private hospitals. (Singapore health care is socialised, but you pay for your care – bit like France). That was a slight divert, as while I was looking, I came across this interesting medical detective story concerning their hunt for patient zero (the initial contact) in an infection cluster. Quite an interesting little story even if I have not answered Singapore’s use of ECMO as imo they are a closer model to our own NHS.

link to Singapore Cluster Story

It also shows that the Singapore Gov is much more expert than the UK in manipulating good stories!

[The VFM Addict]

Singapore has by far the best Covid-19 Dashboard around.  You can look at each individual case in detail including Age, Sex, Nationality and Places visited.   It seems only 4 of all their cases have been over 70.    If you want to explore the Dashboard is here but can at times be slow loading.   Do wait though it is well worth the wait.

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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]

The VFM Addict wrote:

Singapore has by far the best Covid-19 Dashboard around. You can look at each individual case in detail including Age, Sex, Nationality and Places visited. It seems only 4 of all their cases have been over 70. If you want to explore the Dashboard is here but can at times be slow loading. Do wait though it is well worth the wait.

Any thoughts on why there have been so relatively few older age group sufferers? I can only wonder if they do not resort to warehousing older people in infection incubation retorts.

[The VFM Addict]

Basically because Singapore has relatively few of them.   The Population is heavily middle aged loaded.   See here and click the Expand Statistic button.

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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 following is purely educated guesswork on my part, based on many years spent living in Singapore.

My guess would be demographics. Like most Asian countries Singapore is moderately scared of its Malay Muslim neighbours in Malaysia and Indonesia, and during the 21st century they ran a deliberate policy of welcoming young intelligent Chinese in order to better balance (as they saw it) the percent of Chinese versus Malay versus Indian. They roughly doubled the population over ten years and I would guess knocked about ten years off the average age of the country. The other answer would be Chinese New Year – people go home for that two week festival and the period before the New Year was the time that (unknowingly) infection was rife. The young would have gone back to China become infected then gone home (mainly to immigrant Chinese ‘new  towns’, without too many aged occupants. The New Year holiday probably stopped their mixing with the general population (its a stay at home drink Brandy and play Mahjongg period —winning and losing large sums of money in the process)

[The VFM Addict]

I favour incompetence theory over conspiracy theory every time.

That said, to me there is growing evidence that HMG might have concluded that ultimately this virus cannot be contained therefore far better to let it run its course as quickly as possible and hence take a short sharp hit to GDP rather than a slower protected one.

There are no HMG plans to start to restrict large congregations of people.   No plans to close schools leaving open not merely the possibility of the virus spreading in children but, especially in respect of primary schools, huge contagion opportunities during the long parents chats at the school gates at going home time.

I see nothing in HMG’s plans that is convincing that HMG is wholeheartedly seeking to prevent onward transmission.   Their position on masks is totally inconsistent with such claimed strategy.

All of us here and all medical authorities concur that masks at the very least reduce the chances of the infected infecting others.    It this is so then the logical containment strategy is to make mask wearing compulsory.     Indeed, China is of the opinion that compulsory mask wearing which was introduced before the virus had a stranglehold on cities other than Wuhan, where it had exploded before masks became compulsory, has played major part in ensuring spread was less outside Wuhan.

The basic paper masks are not of a kind that hospital staff will wear.   They need better masks.  Therefore making paper masks compulsory in the community does not jeopardise necessary medical supplies.    Paper masks are so easy to produce we could be producing millions a day in the UK within a week if HMG had the will to do so.

I say again the no masks message is so totally inconsistent with HMG’s declared commitment to containment and stopping the infected infecting others that the current no masks message must surely raise doubts about the depth of that commitment to robust containment.

Note – As Covid-19 related matters have now been inconveniently split by the initiation of the Masks thread I am posting the above in both the Mask thread and the main Coronavirus – Covid-19 thread.

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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]

As said before closing schools cuts both ways. It probably eliminates a MAJOR local virus distribution source, BUT it cripples the health service.

I suspect we are now in the brutal min-max choices game. The first ones out of the blocks following covid-19 win. China and Singapore are obvious winners. The strategy of a quick burn has attractions but if ever the electorate in a democracy cottoned on that their Government could be so brutal takes us into uncharted territory I do not think that such a Western Government of Granny-killers could count on the police/military for support.

My bet is that this Government either dithers or leaps BoJo-like  into stupid choices without considering all the details.

[Author]

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