Relaxation of Restrictions, Part III - **Read OP for Mod Warnings**

the kelt

ixoy wrote: »

While I can see where you're coming from, it's a little more complex than that I think:
What defines cases as easing - obviously Dublin having a greater population, you will expect more cases. Do they just mean cases outside of nursing home settings?
If things get rolled back and forth, flip flopping around in Dublin, it'd make it difficult for employers. It'll also make it trickier for the many cafes and the like in the city centre that depend on workers as their customers.

Whatever about employment (where there could be some merit), you won't get away with it on a social level where some counties could go say visit families and others could not.

But to be fair it doesnt have to be just about employment.

It could relate to exercise easing for example or easing of travelling restrictions, opening public amenities etc etc.

the kelt

Princess Consuela Bananahammock wrote: »

It's just one factor. Other things that need to happen before restrictions are eased are making sure there;s enough ICU beds, PPE erquipement. There were fien in total - I think a drop in death rate was one of the others.

Ok so what are the other criteria?

What do the numbers need to be in regards to those criteria?

You dont know, i dont know. Thats one of the issues i have with this.

We keep hearing about whether the numbers are or arent good enough. The only number we ever had some criteria applied to was the R0 number, we met that and are told the numbers arent good enough.

Stop treating us like idiots, why dont they tell us what they are looking at and at what level they need to be at.

Its almost like theyre holding back for a reason??

RebelButtMunch

KrustyUCC wrote: »

I think that section refers to the likes of the Aran Islands

Thank's; I think you're correct. The corresponding text that goes with their diagram says this

Transport and travel
Non-resident tourist travel to offshore islands can resume.

Social distancing and hygiene measures are to continue for public and private transport.

KrustyUCC

They don't want to commit to those numbers publicly

SusieBlue

SusieBlue wrote: »

That’s absolutely horrific, I can’t believe they’ve suspended transplants too. Its disgraceful that they are doing this while lecturing the public about the numbers not being low enough.
What about the numbers of people like your friend? And people waiting on cancer diagnosis and treatments?
Do their lives not matter?

There will be a national scandal in the aftermath of this when the amount of people who couldn’t access healthcare services becomes clear. Heads will roll over this, it will make the cervical check issues look like nothing because it seems to be across all departments of care.

OK, everybody needs to chill the beans here.

First of all, transplant surgeries are not going ahead as you need a stepdown ICU/HDU bed for post surgery.

Secondary, as part of the transplant process, you are going to be immunosuppressed. So a lot higher risk of ill effects of COVID-19.

And, oh wait..... what is the biggest reason people are in ICU at the moment?

COVID-19!

The reason that transplants are not going ahead at the moment is that the risk of doing the surgeries in these conditions is greater than any short term benefit the patient might gain.
Other points to consider:

What if patient who donated their lungs had COVID-19 and it wasn't picked up as no effective screening?
So the medical professionals are acting in the best interests of patients.

growleaves

wakka12 wrote: »

Keep hearing posters say the lockdown is 'killing more people than the virus' because of the stress of fear and being at home, is there anything to back up this statement? People are exercising more, working less and sleeping more. Heart related deaths should obviously be down right now rather than up. Considering they are the people that are always complaining about media scaremongering about the virus, maybe they should look at what they are also saying, there are valid reasons why a lockdown needs to be lifted but obviously it is saving more lives. It is the one benefit youd have to give it..

Relevant article:

Is England’s Lockdown Racking Up The Bodies?

What are those other deaths? Looking at the breakdowns by age (not shown), most of the spike in all deaths comes from those north of 60, both male and female, with stronger signals increasing with age, on average. Usually, people this age are dying from cancer and heart disease (strokes, CHF, MIs, and so on). Are these people not seeking medical treatment as usual? People being turned away? Stress, panic, and fear increased? Suicides?

We’re assuming the corona deaths are real. Very well, there were 22 thousand of these, as of this date. We have to guess, but supposing there was no coronavirus, we’d expect the data to tale down noisily, as it always has. The extra spike wouldn’t be there, by these assumptions. Meaning, with no coronavirus and all its association political and social changes, we’d ordinarily see about 20 + 22 thousand fewer deaths than were observed. The first 20 thousand is the extra spike.

There is, we must admit, considerable uncertainty in that 20 thousand. It isn’t 0, and it isn’t 50 thousand. It’s surely in between, though.
Again, this isn’t proof, but it’s pretty good evidence the lockdowns caused a lot of harm. Physical harm, at the least.

Naturally, officials, realizing the importance of an analysis like this, might go back, like our Yale professors, and claim retroactively that the bodies in the secondary spike are all also coronavirus deaths. But that doesn’t solve the problem, because then, given the absence of spikes in places without lockdowns, it looks like the lockdowns might be responsible for extra corona deaths.

random_banter

SusieBlue wrote: »

That’s absolutely horrific, I can’t believe they’ve suspended transplants too. Its disgraceful that they are doing this while lecturing the public about the numbers not being low enough.
What about the numbers of people like your friend? And people waiting on cancer diagnosis and treatments?
Do their lives not matter?

There will be a national scandal in the aftermath of this when the amount of people who couldn’t access healthcare services becomes clear. Heads will roll over this, it will make the cervical check issues look like nothing because it seems to be across all departments of care.

The front page of the IT today is covering the suspension of BreastCheck and Cervical check. It's one of the first times I've seem a concentrated effort to ask serious questions about what ISN'T happening in healthcare at the moment.

The information I have obviously pertains to a particular kind of transplant (kidneys). I have read on the IT that lung and pancreas transplants are also suspended.

I also know of a woman in her late 30's who's had chemotherapy put on hold due to this. Surely this is the kind of treatment where time is of the essence?

They need a plan to start delivering other healthcare alongside this virus, or there will be more awful heartache. Easy for me to say that as a bystander with no medical expertise of course.

Edit: I've just seen The Dazzler's post above, with good reasoning about immunosuppression - which I was aware of but didn't mention. I suppose my point is they're surely going to need to work out a new way of doing things rather than leaving all these people too long without their treatment? Is there a way to separate patients and healthcare workers for these treatments to non-infected hospitals for example? I know the dialysis unit my friend attends was split in two - non infected patients were sent to a private dialysis unit in a private hospital, while the existing unit they attended was reserved for COVID patients. Dialysis nurses etc do not mix.

wakka12

growleaves wrote: »

Relevant article:

Is England’s Lockdown Racking Up The Bodies?

I'm not too sure about that theory.. generally places with harshest lockdowns had the worst coronavirus outbreaks, so obviously that could be a large contributing factor.

Also he has neglected to mention that there was has been no excess mortality observed in several countries with harsh lockdowns, such as Denmark and Norway and the Czech Republic. Also , its simply not true about no countries without lockdowns not seeing spikes in excess mortality. Indonesia has no lockdown and observed a huge spike in excess mortality rates in Jakarta

https://www.nytimes.com/interactive/2020/04/21/world/coronavirus-missing-deaths.html

MrDavid1976

KrustyUCC wrote: »

Lack of travel and not seeing friends, family, partners etc for months on end is also causing huge hardship

Well to be fair many many people are going to have lots of time on their hands for months on end.....increasing by the day as we take this ultra conservative position. Reduce the stages to two weeks and prepare to combine stages of the numbers point to that.

jmayo

Deleted User wrote: »

OK, everybody needs to chill the beans here.

First of all, transplant surgeries are not going ahead as you need a stepdown ICU/HDU bed for post surgery.

Secondary, as part of the transplant process, you are going to be immunosuppressed. So a lot higher risk of ill effects of COVID-19.

And, oh wait..... what is the biggest reason people are in ICU at the moment?

COVID-19!

The reason that transplants are not going ahead at the moment is that the risk of doing the surgeries in these conditions is greater than any short term benefit the patient might gain.
Other points to consider:

What if patient who donated their lungs had COVID-19 and it wasn't picked up as no effective screening?
So the medical professionals are acting in the best interests of patients.

Excellent knowledgeable post.

Of course the muppets will ignore it and just chomp on about why the hospitals are empty.

There is some cancer treatment going ahead in dedicated non acute hospitals.

One worry I do have is the turnaround in testing, it is much too slow.
And also HSE cannot really employ proper contact tracing of it's own staff if they refuse to tell other staff of someone's positive result, all because they are claiming confidentiality and adhering to fecking GDPR type shyte.

Penfailed

random_banter wrote: »

Have a friend who is on a transplant waiting list. Transplants have been suspended since this started. The friend is getting sicker by the day and it’s showing up in their weekly tests. It’s so distressing that nothing is moving along. And that hope of being called up any day for the transplant is no longer there at all.

That's awful. I put a link up here last week about transplants in NI. They've wiped one third off their kidney transplant waiting lists since the pandemic started. I can't see why this can't happen in the south.

polesheep

Deleted User wrote: »

OK, everybody needs to chill the beans here.

First of all, transplant surgeries are not going ahead as you need a stepdown ICU/HDU bed for post surgery.

Secondary, as part of the transplant process, you are going to be immunosuppressed. So a lot higher risk of ill effects of COVID-19.

And, oh wait..... what is the biggest reason people are in ICU at the moment?

COVID-19!

The reason that transplants are not going ahead at the moment is that the risk of doing the surgeries in these conditions is greater than any short term benefit the patient might gain.
Other points to consider:

What if patient who donated their lungs had COVID-19 and it wasn't picked up as no effective screening?
So the medical professionals are acting in the best interests of patients.

The truth is the medical professionals are not getting a say. Some consultants are practically screaming for their services to be reopened. And there's no reason why a number of ICU beds could not be allocated to transplant patients, or do their lives not matter as much as Covid-19 patients?

The way we report the figures is very suspicious to me. If you removed the nursing home figures and recorded those separately, we’d probably have very low daily cases and a tiny amount of deaths. Maybe even 0 deaths a lot of days.

It’s a nursing home crisis at this point.

3 months of restrictions won’t change that. Sadly, that situation has to play out now.

random_banter

random_banter wrote: »

T
Edit: I've just seen The Dazzler's post above, with good reasoning about immunosuppression - which I was aware of but didn't mention. I suppose my point is they're surely going to need to work out a new way of doing things rather than leaving all these people too long without their treatment? Is there a way to separate patients and healthcare workers for these treatments to non-infected hospitals for example? I know the dialysis unit my friend attends was split in two - non infected patients were sent to a private dialysis unit in a private hospital, while the existing unit they attended was reserved for COVID patients. Dialysis nurses etc do not mix.

By design, ICU/HDU is open planned so hard to segregate. I don't work in transplant anymore but you can't do the surgery without guaranteed stepdown HDU (at minimum). So protecting transplant patients is one issue.

Another issue is are assays sensitive enough to screen for COVID-19 in the transplant organ. An popular culture example of this was in scrubs when they transplanted organs from a patient without appropraite screening leading to Dr. Cox hitting the sauce. It was a very dumbed down but accurate description of pitfalls of proceeding with reckless abandon in transplant surgery.

I also know that there is chemotherapy occurring in my hospital. I think I suppose there is a distinction between essential chemotherapy and chemotherapy. Sometimes, it's appropriate to delay treatment especially if along the lines of CAR-T.

KrustyUCC

https://www.corkbeo.ie/news/local-news/watch-huge-traveller-funeral-draws-18232062

Bloody joke that this is being allowed happen again and again

Mike3287

Deleted User wrote: »

The way we report the figures is very suspicious to me. If you removed the nursing home figures and recorded those separately, we’d probably have very low daily cases and a tiny amount of deaths. Maybe even 0 deaths a lot of days.

It’s a nursing home crisis at this point.

3 months of restrictions won’t change that. Sadly, that situation has to play out now.

And our hospitals

100 new cases from health care workers yesterday

What's the story with that?

Lack of PPE, not using them properly, N95 masks not good enough, N100 needed?

SusieBlue

[Deleted User] wrote: »

The way we report the figures is very suspicious to me. If you removed the nursing home figures and recorded those separately, we’d probably have very low daily cases and a tiny amount of deaths. Maybe even 0 deaths a lot of days.

It’s a nursing home crisis at this point.

3 months of restrictions won’t change that. Sadly, that situation has to play out now.

Apparently 10 different counties in Ireland had 0 new cases the day before yesterday.
Hard to justify such restrictive conditions when that many counties are experiencing 0/extremely low numbers of new cases.

polesheep

polesheep wrote: »

The truth is the medical professionals are not getting a say. Some consultants are practically screaming for their services to be reopened. And there's no reason why a number of ICU beds could not be allocated to transplant patients, or do their lives not matter as much as Covid-19 patients?

What specific services aren't operating? Please could you link to these consultants screaming for their services to be reopened?

Mike3287

KrustyUCC wrote: »

https://www.corkbeo.ie/news/local-news/watch-huge-traveller-funeral-draws-18232062

Bloody joke that this is being allowed happen again and again

It's why our lockdown is a waste of time

Travellers running around in every town with no regard for the law

polesheep

Mike3287 wrote: »

And our hospitals

100 new cases from health care workers yesterday

What's the story with that?

Lack of PPE, not using them properly, N95 masks not good enough, N100 needed?

Nursing homes and care homes also have health care workers (it's a broad term) and they have been hit very hard, mostly due to a lack of PPE. We should be given a breakdown of the location of affected health care workers.

Stheno

polesheep wrote: »

The truth is the medical professionals are not getting a say. Some consultants are practically screaming for their services to be reopened. And there's no reason why a number of ICU beds could not be allocated to transplant patients, or do their lives not matter as much as Covid-19 patients?

Have they sorted out the issues with the contracts for the private consultants? There was something on the news yesterday about using the National Treatment Fund to fund private treatments for people

KrustyUCC wrote: »

https://www.corkbeo.ie/news/local-news/watch-huge-traveller-funeral-draws-18232062

Bloody joke that this is being allowed happen again and again

Why can't the police simply stop these happening? Are they afraid of being accused of discrimination? The rate of positive cases amongst travellers tested is 48% so in theory up to half the people at that funeral could be positive

And where are Pavee Point calling for this to stop?

polesheep

Deleted User wrote: »

What specific services aren't operating? Please could you link to these consultants screaming for their services to be reopened?

Yes, if you wait a moment I will name consultants on an anonymous forum and await the legal letter that follows.

I can tell you for a fact that some endoscopy units are closed.

Stheno

Deleted User wrote: »

What specific services aren't operating? Please could you link to these consultants screaming for their services to be reopened?

It was on I think the Tonight Show last week, private consultants who have not signed the new contract with the HSE as they are not having their private rooms covered?

So they are currently sitting at home as they cannot access the private hospitals.

Hopefully it gets sorted out sooner rather than later.

random_banter

Deleted User wrote: »

By design, ICU/HDU is open planned so hard to segregate. I don't work in transplant anymore but you can't do the surgery without guaranteed stepdown HDU (at minimum). So protecting transplant patients is one issue.

Another issue is are assays sensitive enough to screen for COVID-19 in the transplant organ. An popular culture example of this was in scrubs when they transplanted organs from a patient without appropraite screening leading to Dr. Cox hitting the sauce. It was a very dumbed down but accurate description of pitfalls of proceeding with reckless abandon in transplant surgery.

I also know that there is chemotherapy occurring in my hospital. I think I suppose there is a distinction between essential chemotherapy and chemotherapy. Sometimes, it's appropriate to delay treatment especially if along the lines of CAR-T.

Thank you, it's great to get the POV from someone with medical knowledge. I get the other side of the story from a patient's POV which is very much a person who is in the dark about why some of these decisions are being made.

Can I ask, do you have a perspective on how this might be resolved in the medium term (with social distancing in place for the foreseeable as well as being told the virus will be around a lot longer)? How do you think situations like this may play out? Or perhaps you don't have an answer, lots of the things we're being posed with don't have answers these days.

polesheep

polesheep wrote: »

Yes, if you wait a moment I will name consultants on an anonymous forum and await the legal letter that follows.

I can tell you for a fact that some endoscopy units are closed.

Some endoscopy are elective, also an endoscopy is an aerosol producing activity so high risk for spreading of COVID-19 hence why elecitve ones have been cancelled.

However, there has been no delay in emergency endoscopies/colonoscopies. I have had two of my patient's have endoscopies today.

You talk a lot about "facts" when really you are pandering misinformation.

KrustyUCC

Stheno wrote: »

Why can't the police simply stop these happening? Are they afraid of being accused of discrimination? The rate of positive cases amongst travellers tested is 48% so in theory up to half the people at that funeral could be positive

And where are Pavee Point calling for this to stop?

Probably be acussed of racism alright

That and they don't want to deal with the hassle imo

I know of people who had to bury relatives recently

Rules apply to them. Their grief is no less

Huge potential for cases to spread at huge funerals

The law should be the same and policed the same for all

SusieBlue

[Deleted User] wrote: »

What specific services aren't operating? Please could you link to these consultants screaming for their services to be reopened?

Cervical check & smear services are suspended.
My colposcopy appointments have been cancelled until further notice, I usually have one every few months, due to the presence of pre-cancerous cells that I’ve had for the last few years. It’s to keep an eye on them to ensure they haven’t mutated into cancer.
As I don’t actually have cancer my screening appointments are not considered urgent enough so they have been cancelled.
I know a lady who actually does have cervical cancer whose treatment has been significantly delayed due to new social distancing measures in operation in the clinic.

random_banter

random_banter wrote: »

Thank you, it's great to get the POV from someone with medical knowledge. I get the other side of the story from a patient's POV which is very much a person who is in the dark about why some of these decisions are being made.

Can I ask, do you have a perspective on how this might be resolved in the medium term (with social distancing in place for the foreseeable as well as being told the virus will be around a lot longer)? How do you think situations like this may play out? Or perhaps you don't have an answer, lots of the things we're being posed with don't have answers these days.

1) Quicker assays for detection of SARS CoV-2
2) Elimination of community transmission (unlikely!)
3) Have a facility with HDU/ICU beds that would not be allowed to have COVID-19 patients.

I feel we are reasonably close to resumption of elective cardiology/transplant surgery with stepdown HDU/ICU beds.

tobefrank321

jmayo wrote: »

Excellent knowledgeable post.

Of course the muppets will ignore it and just chomp on about why the hospitals are empty.

There is some cancer treatment going ahead in dedicated non acute hospitals.

One worry I do have is the turnaround in testing, it is much too slow.
And also HSE cannot really employ proper contact tracing of it's own staff if they refuse to tell other staff of someone's positive result, all because they are claiming confidentiality and adhering to fecking GDPR type shyte.

In certain counties, the threat from covid 19 is far far less than the threat of cancer from delayed or missed diagnosis. The same for transplants.

Its a question of balancing risks. Yes in high risk areas, you have to delay some other health services.

But in low risk counties it makes little sense to be so fearful of the minimal risk of covid 19 that you stop everything.

Its a pity our government didn't make a serious effort to keep covid 19 out of the country in February and March but I suppose that's a discussion for another day. Even still we are like a sieve letting new cases into the country.

The health and economic toll of this unwillingness to control our borders has been massive.

uli84

SusieBlue wrote: »

Cervical check & smear services are suspended.
My colposcopy appointments have been cancelled until further notice, I usually have one every few months, due to the presence of pre-cancerous cells that I’ve had for the last few years. It’s to keep an eye on them to ensure they haven’t mutated into cancer.
As I don’t actually have cancer my screening appointments are not considered urgent enough so they have been cancelled.
I know a lady who actually does have cervical cancer whose treatment has been significantly delayed due to new social distancing measures in operation in the clinic.

Add to that diabetic retina screens. Retina damage give 0 symptoms until in a very very advanced stage