The UK response - Part II - read OP

The Head of the NHS's definition of an overwhelmed service seems very far removed from my initial statement about the strain and pressure COVID is continuing to have on the NHS. Even the full article title seems like an oxymoron to me.

If the NHS was not overwhelmed (or under strain & pressure which was what I originally said) then why is it not operating as per usual as opposed to cancelling pre-planned procedures? Based on other Amanda Pritchard quotes it looks like her definition of 'overwhelmed' is closer to having masses of people left to die in hospital courtyards.

It's also worth nothing that the third paragraph of that article highlights that those working on the front line have accused her of 'gaslighting'. Again, probably down to a very different definition of 'an overwhelmed NHS'.

"Quite what the **** the NHS is going to do with all that testing capacity after this is all over though, god knows. Maybe they should have spent the money imprving the countries general scientific facilities?"

Testing capacity in NHS labs wont just suddenly become useless or obsolete. Those PCR platforms can be used to detect, influenza, RSV, and other respiratory viruses from one swab. All of those resources and equipment is an investment in the future of molecular diagnostics for NHS hospitals.

That Sunday Post piece is precisely what i was talking about - there were loads of lab and medical directors contacting the government in march/april offering their services only to be rebuffed or simply ignored. Paul Nurse of the Francis Crick Institute is another, one of many. They could have opted to help develop these labs, in conjunction with the nhs and public health bodies, turning tests around within 24 hours and enabling contact tracing to get going much more quickly and effectively than it did. But they chose not to do this and went instead for a centralised private system that was beset by multiple and sustained problems from the beginning and took ages to be properly streamlined with the public health system. As I said earlier, i don't think engaging the private sector was a bad or wrong thing in itself, it was the manner in which it was done that wreaked so much damage and cost so many lives.

Then why was it and the lab in Wolverhampton a disaster?

Maybe because running a lab with volunteers with no experience or training in diagnostic testing leads to contaminated, compromised patient results.

The IBMS warned against this and appealed for labs that perform covid testing to abide by a proper quality management system.

https://www.ibms.org/resources/news/high-quality-staff-deliver-high-quality-services/

When there was thousands of people in Ireland looking for a covid test and capacity couldn't meet demand, the criteria for testing changed to try and capture the people with the worst symptoms. Testing wasn't farmed out to a private company offering the best deal.

People were saying things like " sure there's loads of labs in universities and pharmaceutical companies. Just use them to do covid testing." That would have been an uncontrolled disaster.

People think a lab is a lab and automation does most of the work.

Diagnostic testing is completely different. And has to be done right when it's patients health that's at risk.

And on the RTE website, the daily numbers are instantly top of page. Covid is still in our national conciousness.

And even as you say, our last reported comparative figure is 550 deaths per week... that compares to a UK average of 162 per day, literally double per week and with a steady upward trend in the UK.

So my point is, we're still fairly aware and focused on Covid here, with constant debate about what's needed, masks still very much in evidence, vaccinations at well above 90% and boosters being rolled out. Also a clear, unified political message on what needs to be done.

In the UK, with double the death rate, masks have become a political issue (look at Govt non-mask wearing, Opposition all mask wearing benches at PMQs last week), the daily reporting of numbers is nowhere near headline news, Covid is being ignored

I'm not sure why people would be starting to lose faith in the numbers. If that is the basis for the UK count, the numbers have been calculated on the same basis all along, surely?

If anything, the reverse should be the case. As the excess deaths figures for the UK become available, it seems likely that the official count of people who are recorded as dying in consequence of Covid is significantly understating the impact of the pandemic.

(It should be pointed out that the "within 28 days" metric is only used for immediate measurements of Covid deaths. It's used because these are reported on a daily basis, before the death certificates (which state a medical opinion as to the cause of death) are available. When the death certificates become available corrected figures can be prepared - deaths within 28 days of testing, but where Covid is not stated as a cause of death on the certificate subtracted; deaths later than 28 days but where Covid is stated added. In practice the corrections have been modest, which suggests that, as a technique for getting reasonably reliable figures rapidly, the 28-day rule is pretty robust.)

It's a big jump from 40 yesterday isn't it ?

It doesnt change the fact that this seems to be the way deaths have been counted since this all started though. For what reason would people start losing faith in this if its how its always been?

Covid is mentioned in the death certificate if it is, in the opinion of the certifying medic, the cause or one of the causes of death. It is not routinely mentioned if the patient had tested positive for Covid.

You raise an interesting question: If people are vaccinated and the booster programme is proceeding well, what more can be done? But it begs a prior question: does anything more need to be done? And that depends on what infection or death rates are like. If infection, hospitalisation or death rates are problematically high, then something needs to be done. If "yet more vaccination" seems likely to yield diminishing returns, the something needs to be something else - other infection control measures.

I've seen people urging the idea that we have to learn to "live with Covid", by which on investigation they seem to mean that we should live as if we didn't have Covid - take no further precautions or measures. This doesn't seem rational to me. If the protection achieved by vaccination is high but not high enough, then we have to supplement it with other measures, which may be permanent or at least indefinite until we e.g. develop other and more effective vaccines. It could be social distancing measures, it could be masking in shared spaces, it could be something else. There is no law of God or nature that says we will ever arrive at a position where we can live as if the Coronavirus had never evolved, and suffer no adverse consequences for doing so.

And that has nothing to do with the fact that deaths have been counted the same way this whole time so i still dont understand what peoples problem is.

That's good to hear. The concern must be that uptake has significantly slowed down since that milestone has been reached,