CoVid19 Part XII - 4,604 in ROI (137 deaths) 998 in NI (56 deaths)(04/04) **Read OP**

macmahon

igCorcaigh wrote: »

Because of how it rises exponentially. It's not the numbers of people currently dying from this is the concern, tragic as it is. But how it could swamp our health services. And, it's a new illness. How things could go from this now to something much worse very quickly, if we don't act.

It's a very interesting thing McM. It involves epidemiology, risk management, politics, medicine.... There are good reasons for the current measures.

Thankyou for your explanation....Im seeing politics as more of an issue!

cnocbui

https://twitter.com/FaheemYounus/status/1245547129831067649

Interesting.

Etc

Love this bit,

"I was laughed at and mocked by some but as l said at the time they laughed at Noah until the rain started"

Insightful stuff as always from the DUP

igCorcaigh

macmahon wrote: »

Thankyou. I understand your last sentence but not your first! Where is this exponential growth?

https://www.worldometers.info/coronavirus/#countries

stephenjmcd

Bobtheman wrote: »

I was a bit surprised at the Department of education being so adamant that they will run the LC somehow in June. By hook or by crook. They said. Reminds me of the promise that the bank bailout would be only 8 billion . Ah the memories. Great times.

Because chances are by June there will be some sort of reopening of the country. I'd move them to July if it was at all possible. Students just need clarity really, all the work is built towards exam day so they need to know the dates for the exams

Just Saying

Achasanai wrote: »

I presume the poster means per head of population. We're not quite at Belgium's level (when comparing in terms of days since the first death) but far ahead of the UK, Sweden, Italy, US on day 9 (per head of population).


http://91-divoc.com/pages/covid-visualization/

Maybe I am not changing some setting but those graphs relate to cases.Cases cannot be compared accurately because of the gulf in tests or head of population.

igCorcaigh

macmahon wrote: »

Thankyou for your explanation....Im seeing politics as more of an issue!

Yes. Me too.

I'm just highlighting how something like a pandemic has cross cutting concerns. Whatever field you are interested in, it will affect it.

I guess for me, that's what makes it interesting.
But hey, this is how I survive, I'm quite detached from things. Even in tough times.

stephenjmcd

eagle eye wrote: »

The simple solution is complete lockdown which means a temporary border with NI, nobody in or out of the country, unless out means you stay gone, and we'll be clear of this thing before June.
Of course that sorts this country out and not the rest of the world. We need to maintain the lockdown as far as entry to the country is concerned until the rest of the world is clear of it.

We can all be back at work by June though if they do things right.

Your having a laugh right ? Create borders, stop the flow of goods into the country, a temporary border a sitting duck for paramilitary attacks. Theres not a hope of the countries borders being closed, we wouldn't even have the man power to impose a border with NI. Think about this logically.

Theres really nobody coming into the country through the airports as it is anyway

amadangomor

macmahon wrote: »

Thankyou. I understand your last sentence but not your first! Where is this exponential growth?

If we had done nothing and had no restrictions you would have seen exponential growth. Our ICU's would be overwhelmed by now and we would have many excess deaths.

Being realistic there is still a good chance even with the restrictions we have in place that we will get to a stage where our health service will be overwhelmed in a few weeks. Then we will see those excess deaths.

It's that serious!

Roger_007

There is something very strange going on with the health service. The A&Es are empty, the wards are virtually empty, (according to Dr Holohan anyway). What happened to all the patients who were on trolleys a couple of weeks ago. Were there a lot of people going to A&E who didn’t need to, or are they afraid to go now?
Is it possible that people are so scared of getting Covid19 that they not going to their doctors or to A&E even when they really should. Could this be an unintended consequence of the ‘cocoon’ policy?

igCorcaigh

Even with restrictions, the growth is still exponential, just at a slower rate. The doubling time slows, but its still a doubling time.

But, the plus side of exponential growth, means there is also exponential decay. Once we get the R0 below 1, the cases drop to zero very quickly. That's what we have seen in China.

OK, don't argue about the veracity of Chinese figures, I'm talking about the maths

josip

Funsterdelux wrote: »

Whats this lady on primetime got against masks.

They thought us how to wash our hands

They thought us how to keep our distance

They can teach us how to wear a f00king mask

Plenty of other things they could teach us too...

Strazdas

bekker wrote: »

'Talk from scientists', what scientists? what forum? what specialities? etc. etc.

Microdroplet transmission, expiration etc has been in the frame from the beginning.

The "two metre rule" wasn't being discussed in the first week in February. If I remember correctly, it only began to emerge towards the end of the month.

Curious_Case

BanditLuke wrote: »

I'd say July at the earliest and then another shutdown in October for longer this time with the much more letal second wave.

Personally, I think that a second wave would, by definition, be less serious.

Three reasons:

The counry would be more prepared 2nd time around.

The country would be more vigilant going forward from 1st wave.

For the reasons listed above, a 2nd wave would not be able to establish itself to the extent that the 1st wave did as it would be noticed earlier and acted upon with greater efficiency.

Not to mention the fact that some of the population would already have been exposed to, and recovered from (or had no symptoms from) the 1st wave.

tuxy

Roger_007 wrote: »

There is something very strange going on with the health service. The A&Es are empty, the wards are virtually empty, (according to Dr Holohan anyway). What happened to all the patients who were on trolleys a couple of weeks ago. Were there a lot of people going to A&E who didn’t need to, or are they afraid to go now?
Is it possible that people are so scared of getting Covid19 that they not going to their doctors or to A&E even when they really should. Could this be an unintended consequence of the ‘cocoon’ policy?

So many factors. Some do not want to go because they think it's wasting time of the medical staff. Many people who go to A&E actually have mental health issues.
Drinking at home causes less injuries than drinking in pubs and on the streets.

Leo warned in his speech today that if you have medical issues you need to have it looks at. They are aware people are avoiding hospitals.

gabeeg

Curious_Case wrote: »

Personally, I think that a second wave would, by definition, be less serious.

Three reasons:

More prepared 2nd time around

More vigilant going forward from 1st wave

For the reasons listed above, a 2nd wave would not be able to establish itself to the extent that the 1st wave did as it would be noticed earlier and acted upon with greater efficiency.

what if it hits a population in the grip of an economic depression?

igCorcaigh

Roger_007 wrote: »

There is something very strange going on with the health service. The A&Es are empty, the wards are virtually empty, (according to Dr Holohan anyway). What happened to all the patients who were on trolleys a couple of weeks ago. Were there a lot of people going to A&E who didn’t need to, or are they afraid to go now?
Is it possible that people are so scared of getting Covid19 that they not going to their doctors or to A&E even when they really should. Could this be an unintended consequence of the ‘cocoon’ policy?

I'm curious about this too.

Maybe all the things you mentioned.

Maybe people not being referred to AE because they can't or won't see their GP?

Bed blockers sent home?

Less private patients being kept in by the hospitals because ching ching?

I don't know.

amadangomor

Roger_007 wrote: »

There is something very strange going on with the health service. The A&Es are empty, the wards are virtually empty, (according to Dr Holohan anyway). What happened to all the patients who were on trolleys a couple of weeks ago. Were there a lot of people going to A&E who didn’t need to, or are they afraid to go now?
Is it possible that people are so scared of getting Covid19 that they not going to their doctors or to A&E even when they really should. Could this be an unintended consequence of the ‘cocoon’ policy?

Hopefully we come up with solutions in the future that will reduce the numbers going to A&E unnecessarily in the future.

Maybe some intermediate health clinics to triage better. Of course GPS need to look at their practice of sending people too quickly to A&E also.

On the other side of the coin there could be people now who genuinely should be there and are too scared to go/don't want to waste doctors time.

New Home

Words I'm now hating due to these threads:

1. "Scaremongering"
2. "Triage"
3. "Cocooning"
4. "Social distancing" (ok, fair enough, that's two words)
5. "Doomsayers"

I'm sure I had more to add to the list, but I'll do that as soon as I remember them.

Please, bring back "Moist".

stephenjmcd

igCorcaigh wrote: »

Even with restrictions, the growth is still exponential, just at a slower rate. The doubling time slows, but its still a doubling time.

But, the plus side of exponential growth, means there is also exponential decay. Once we get the R0 below 1, the cases drop to zero very quickly. That's what we have seen in China.

OK, don't argue about the veracity of Chinese figures, I'm talking about the maths

Its not possible to conclude growth is exponential even with restrictions. Cases being announced were picked up at least 2 weeks ago before any tough measures came in. We wont see the reflection of current measures for at least another week to 2 weeks which the CMO has been pretty clear about.

We've cut the average close contacts from 20 to 5 to 3 which would suggest growth will slow.

As for china I've given up even paying attention to anything coming out of there, theres not a chance those figures at legitimate

Podge201

New Home wrote: »

Words I'm now hating due to these threads:

1. "Scaremongering"
2. "Triage"
3. "Cocooning"
4. "Social distancing" (ok, fair enough, that's two words)
5. "Doomsayers"

I'm sure I had more to add to the list, but I'll do that as soon as I remember them.

Please, bring back "Moist".

Fingering

Strazdas

tuxy wrote: »

So many factors. Some do not want to go because they think it's wasting time of the medical staff. Many people who go to A&E actually have mental health issues.
Drinking at home causes less injuries than drinking in pubs and on the streets.

Leo warned in his speech today that if you have medical issues you need to have it looks at. They are aware people are avoiding hospitals.

I'd say many people are terrified of actually contracting Covid at the hospital : either in the A & E waiting room, the cubicles or up on the ward.

They may be thinking they are a hundred times safer at home.

bekker

Roger_007 wrote: »

There is something very strange going on with the health service. The A&Es are empty, the wards are virtually empty, (according to Dr Holohan anyway). What happened to all the patients who were on trolleys a couple of weeks ago. Were there a lot of people going to A&E who didn’t need to, or are they afraid to go now?
Is it possible that people are so scared of getting Covid19 that they not going to their doctors or to A&E even when they really should. Could this be an unintended consequence of the ‘cocoon’ policy?

Don't think it's necessarily to do with 'cocooning'
(ridiculous catch-phrase "Wrapping you in a warm blanket of protection" .. "Sorry we f'd up in care homes, we're taking your career)

More to do with a marked reluctance to become exposed in high risk areas, and the possibly subliminal belief that many people die of hospital acquired infections.

gabeeg

igCorcaigh wrote: »

I'm curious about this too.

Maybe all the things you mentioned.

Maybe people not being referred to AE because they can't or won't see their GP?

Bed blockers sent home?

Less private patients being kept in by the hospitals because ching ching?

I don't know.

If you fractured a finger right now, would you go to hospital?

Psychedelic Hedgehog

New Home wrote: »

Words I'm now hating due to these threads:

1. "Scaremongering"
2. "Triage"
3. "Cocooning"
4. "Social distancing" (ok, fair enough, that's two words)
5. "Doomsayers"

I'm sure I had more to add to the list, but I'll do that as soon as I remember them.

Please, bring back "Moist".

6. "Furlough".

beolight

Roger_007 wrote: »

There is something very strange going on with the health service. The A&Es are empty, the wards are virtually empty, (according to Dr Holohan anyway). What happened to all the patients who were on trolleys a couple of weeks ago. Were there a lot of people going to A&E who didn’t need to, or are they afraid to go now?
Is it possible that people are so scared of getting Covid19 that they not going to their doctors or to A&E even when they really should. Could this be an unintended consequence of the ‘cocoon’ policy?

The hospitals have used the funds freed up to them by the HSE to move all the bed blockers out to healthcare facilities in the community.

They haven’t gone away you know just in a less resource rich location

New Home

Psychedelic Hedgehog wrote: »

6. "Furlough".

I haven't seen that word being used here too much, but give it time, it may yet make my top 10. :cool:

macmahon

Henry Scary Tights wrote: »

The difference between the 90 deaths per day, is that they are largely not due to contagious illnesses. If somebody sadly passes away from a heart attack, (s)he will not spread this. However, in the case of a contagious illness, this can be spread, and lead to an exponential (massive explosion of case) increase in the number of cases. About 6% of all cases will require critical care (which requires an incredible amount of resources per patient). Furthermore, each patient will require approximately 10-12 days of critical care. Since, Ireland (like every country in the world) has only a finite number of critical care beds, we have to try to reduce the overall rate of spread. By doing this, we reduce the number of patients requiring critical care at any given time. This ensures that people who are otherwise appropriate candidates for critical care will both receive critical care, and receive optimal care. If we let the virus spread like wildfire, the hospital-system starts to fall apart. Medical systems are expected to function in a chaotic and overwhelmed system.

Social restrictions has been demonstrated to reduce the transmission of the illness

Thank you...I understand that. Are covid19 patients overwhelming our hse system at the moment here in Ireland?...or people suffering from coronavirus the flu etc? You sound like someone who works in that area to have such knowledge. Can you spill?

igCorcaigh

stephenjmcd wrote: »

Its not possible to conclude growth is exponential even with restrictions. Cases being announced were picked up at least 2 weeks ago before any tough measures came in. We wont see the reflection of current measures for at least another week to 2 weeks which the CMO has been pretty clear about.

We've cut the average close contacts from 20 to 5 to 3 which would suggest growth will slow.

As for china I've given up even paying attention to anything coming out of there, theres not a chance those figures at legitimate

Yeah I agree with you.

I guess I'm coming from a maths argument.
And I'm not good at maths at all.

Watched Bill Gates new TED interview.
He explained how exponential decay can in fact bring cases to zero very quickly if you bring the reproduction rate to under one.

Can't embed.

https://youtu.be/Xe8fIjxicoo

Curious_Case

gabeeg wrote: »

what if it hits a population in the grip of an economic depression?

My thinking is that much of the testing & treatment infrastructure would still be in place so a similar spend/investment would not be required.

Also, we would have a better knowledge of how much to do, when to do it, and how long to do it for.

I would hope that a 2nd wave would be more manageable than the current wave due to case numbers being smaller.

Then again, a mutated form of the virus could turn all that upside down.

I'm really just trying to dampen the idea that a second wave would necessarily be worse, when it couldn't possibly take us as much by surprise as the current crisis.

cnocbui

10 million Americans have now registered as unemployed. The Dow surged +2.24 % today. Who can help? I think I have terminal cognitive dissonance, or else I'm dreaming and will wake up to the alarm shortly.

Ellsbells1

stephenjmcd wrote: »

Because chances are by June there will be some sort of reopening of the country. I'd move them to July if it was at all possible. Students just need clarity really, all the work is built towards exam day so they need to know the dates for the exams

I can see this happening, all he said was they are going to go ahead in the summer and college to start in October. He didn’t commit to June and colleges normally begin in September so I think they are planning for July.

giveitholly

Psychedelic Hedgehog wrote: »

6. "Furlough".

7 "WOW"
8 "FFS"

macmahon

Beanybabog wrote: »

How long do people think the ban on family visits will be?

That depends on you and whether you like them or not!

Spook_ie

So interesting report on Breaking News, wonder if there's a practical way of proving/disproving it?

https://www.breakingnews.ie/world/smell-test-campaign-could-help-experts-track-coronavirus-spread-991853.html

Professor Kumar, 55, said those with a cold or flu mention losing their smell to him “only once in a blue moon”, whereas it is a common complaint for Covid-19 patients.

In a survey, led by the professors, of 2,500 people with signs of coronavirus, a “staggering” one in six reported anosmia as their only symptom. Of those who reported losing their sense of smell, 74% tested positive for coronavirus.

King’s College London experts also found through analysis of two million users on their symptom tracker app, 59% of those who tested positive for Covid-19 reported a loss of smell.

The #CovidSmellTest, which will encourage people to sniff household objects such as a cup of coffee and report any sudden loss of smell on social media, is being developed by the professors alongside former chief risk officer for JP Morgan, Peter Hancock.

citysights

The thing is and it has been raised before on this thread is whether or not people are dying of covid or with covid. It seems to be an important point in terms of classification of death.

Like if someone had an underlying health condition did covid cause their death ( assuming they tested positive for it) or was it the underlying condition that caused their death.Surely this is an important distinction to make and is that distinction being made currently.

macmahon

bekker wrote: »

Not shorthand, sloppy.

Sloppy language leads to sloppy thinking, and there's enough of that are around already.

Thinking COVID-19 = coronavirus negates the ability to correctly filter memes on coronavirus.

Misinformation has an R0 of >10k.

capital.....YES!

Refractions

Solli wrote: »

I’m going to paste a previous post, it’s not the ventilators that are the issue here

Interesting read from a health sector worker in the UK.

I'll be honest, as I see it due to working in Intensive Care. The lack of ventilators, which the government is falling over itself to sort, is not the biggest issue at the moment, it'll be the lack of suitably trained people to operate the ventilators effectively, as part of overall care for a critically unwell patient.

You can give (and we are) non-Intensive Care nurses basic training on ventilators but, as experience is showing, many Covid-19 patients that are being ventilated on Intensive Care Units are effectively in multi organ failure, requiring wider treatment than 'just' ventilation.

Even those patients who aren't in multi organ failure require more complex treatment regimes due to the nature of the high pressures required for effective ventilation and to keep patients as sedated as we can in order that they are compliant with the ventilation settings.

(My apologies but some 'shop talk' will appear now, I'll link to articles explaining what I'm talking about where I can)

We are having to heavily sedate patients far deeper than the levels we usually aim for.

Usually we try to sedate patients to a RASS of 0 to -2, which means patients are very lightly sedated, often able to breath spontaneously under the sedation. This helps maintain strength in muscle groups required for breathing and means that hospital stays are shortened, less rehabilitation is required and patients outcomes are overall much better.

With Covid-19 though we are having to ventilate patients with much higher pressures than we normally would in order to counter the effects of the pneumonia that it causes. These higher pressures cause issues with patients not 'sycronising' with the events, in short because the body finds it uncomfortable and triesto resist (desyncronising). As a result we're generally having to sedate patients to a RASS of-4 to -5 (so-called "flattening them out") and are very often also having to use paralysing medications to ensure total compliance.

This level of sedation then introduces other issues, predominately sedation-related hypotension (low blood pressure), for which we then have to give other medications (inotropes) in order to vasoconstrict the vascular system and keep blood pressure high around the core organs to keep them perfused (well oxygenated via blood flow).

Using inotropes though has a knock-on issue of it's own, or rather two predominate ones; lower blood pressure in kidneys and poor blood flow at the extremities. The former causes a reduction in urine production, leading to poor excretion of harmful waste products within the blood stream, the latter can lead (in extreme case) to necrosis (cell death from oxygen starvation).

To add to this, we are unable to directly treat Covid-19 as there is currently no cure, so we're relying upon patients own immune system to deal with it. This causes other issues, among them; the immune response requiring large amounts of glucose to be released into the blood system to 'feed the body' and, as a consequence of so much glucose being used metabolically, an increase in the amount of Ketones within the blood.

The large amount of glucose needs to both be supplemented (through Nasogastric Feeding) and controlled (with Insulin) to try and restrict the levels of blood glucose. If left unchecked the body will just keep glucose (causing Hyperglycemia) and 'burning it' metabolically and in doing so releasing increasing amounts of Ketone (which is an acid, so causing Ketoacidosis). This rise in acidity, compounded by a drop in urine output, causes a drop in blood Ph, which is incredibly damaging to all parts of the body at a cellular level.

Whilst there is far more involved in looking afte a patient on Intensive Care I hope that this brief explanation shows that 'merely' putting someone on a ventilator has a knock-on to multiple organ groups, all that in turn have a knock-on to other ones.

Teaching someone to operate a ventilator is (comparatively) simple. Teaching someone how to titrate medications, adjust ventilator settings, when to give additional medications to address issues with observed patient 'vitals' etc is not. This is why, as I mentioned earlier in the thread, it can take 12-18 months of additional specialist training before a registered nurse can operate safely as an Intensive Care nurse.

We have to be able to keep the most dependant patients alive without the benefit of calling a doctor for advice all the time. Indeed, generally, the junior doctors will cede to the knowledge of nurses with regards to Intensive Care patients as we're often far more experienced in such s specialist ares than they are (due to the nature of their training/placement program).

- Ventilators are not the sole issue.

Having had my Dad in intensive care for a few weeks, I can vouch for all this. The amount of machines/tubes he was hooked up to was mind boggling.

igCorcaigh

Spook_ie wrote: »

So interesting report on Breaking News, wonder if there's a practical way of proving/disproving it?

https://www.breakingnews.ie/world/smell-test-campaign-could-help-experts-track-coronavirus-spread-991853.html

I regularly lose my sense of smell and taste with winter colds...

Spook_ie

New Home wrote: »

Words I'm now hating due to these threads:

1. "Scaremongering"
2. "Triage"
3. "Cocooning"
4. "Social distancing" (ok, fair enough, that's two words)
5. "Doomsayers"

I'm sure I had more to add to the list, but I'll do that as soon as I remember them.

Please, bring back "Moist".

Virus laden mucus is moist!

brooke 2

paleoperson wrote: »

Clown professor on Prime Time still trying to argue masks don't work and the fool public would end up infecting themselves.

Changed stations at that stage! :mad:

stephenjmcd

igCorcaigh wrote: »

Yeah I agree with you.

I guess I'm coming from a maths argument.
And I'm not good at maths at all.

Watched Bill Gates new TED interview.
He explained how exponential decay can in fact bring cases to zero very quickly if you bring the reproduction rate to under one.

[YouTubel]Xe8fIjxicoo[/YouTube]

I'm open to being proven completely wrong if our numbers blow up beyond anything any of us could have imagined in the next few weeks but I do think theres a high degree of compliance with the measures in place.

Personally I estimated at the start that between working in an office and everything else I probably had about 25 - 30 close contacts each week. For the past 3 weeks I've barely spent 2 minutes even talking to someone in person outside of the 3 in the house. So it's been a complete change in behaviour.

It'll be interesting to see when this is all over how much attention we pay to who our close contacts are in future, I can see alot more people working from home 1 or 2 days a week if its possible.

frillyleaf

Roger_007 wrote: »

There is something very strange going on with the health service. The A&Es are empty, the wards are virtually empty, (according to Dr Holohan anyway). What happened to all the patients who were on trolleys a couple of weeks ago. Were there a lot of people going to A&E who didn’t need to, or are they afraid to go now?
Is it possible that people are so scared of getting Covid19 that they not going to their doctors or to A&E even when they really should. Could this be an unintended consequence of the ‘cocoon’ policy?

I say there are a lot less risks being taken on a daily basis too. There are very few people working, driving, etc compared to normal. I would think that people are too scared to go near a&e and will only go to doctors or a&e as a last resort. I also know of people who were referred to a&e to get into the system for treatment in non emergency situations which is understandable as the waiting lists are so long and they can’t wait weeks or months so just got sent to a&e

spookwoman

Anyone else fed up with people posting videos of themselves doing ****. Seems to have brought out the attention seekers in their droves.

hotmail.com

Miriam back presenting the Late Late tomorrow.

Tubridy must be raging.

CitizenFloor

My slightly modified question still stands. It's a question worth asking.

Sorry to hear about your Dad by the way. Hope all is well

owlbethere

gabeeg wrote: »

If you fractured a finger right now, would you go to hospital?

A fractured finger wouldn't be too bad. You could get someone to split it for you, take ibuprofen and wait it out for a few weeks.

I would probably need a limb have hanging of me before I would go anywhere near a hospital.

igCorcaigh

macmahon wrote: »

capital.....YES!

Agreed, but they (WHO) where late in naming it. The sloppy name stuck, unfortunately.

frillyleaf

Strazdas wrote: »

The "two metre rule" wasn't being discussed in the first week in February. If I remember correctly, it only began to emerge towards the end of the month.

The 15 minute rule was being spoken about - don’t think many took their chances somehow

Roger_007

New Home wrote: »

Words I'm now hating due to these threads:

1. "Scaremongering"
2. "Triage"
3. "Cocooning"
4. "Social distancing" (ok, fair enough, that's two words)
5. "Doomsayers"

I'm sure I had more to add to the list, but I'll do that as soon as I remember them.

Please, bring back "Moist".

We could also resurrect Charlie Haughey’s GUBU phrase to describe the present situation:-
Grotesque
Unbelievable
Bizarre
Unprecedented.