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Visitor Contributions

A Rational Reopening Guide

In the interest of public debate, we allow visitors to share opinions, experiences and research that may be of value to others. This is a visitor contribution from our Discussions page.

The views expressed are those of the individual posters themselves. Please read our Comments and contributions disclaimer.

Author

Megan Mansell

  • Credentials: Megan Mansell is a former district education director over special populations integration, serving students who are profoundly disabled, immunocompromised, undocumented, autistic, and behaviorally challenged; she also has a background in hazardous environs PPE applications. She is experienced in writing and monitoring protocol implementation for immunocompromised public sector access under full ADA/OSHA/IDEA compliance.
  • E-mail: [email protected]
  • Twitter: @mamasaurusMeg

A Rational Reopening Guide

A framework for operating any facility or business during COVID

The United States already has a body of law that requires making accommodations for persons with disabilities; if we start from the premise that Americans should be able to determine the level of risk they’re willing to take, all of those concepts can be extended to provide accommodations to anyone who is concerned about exposure to COVID, whether because they are vulnerable or because they live with someone who is vulnerable.

The first step is to ask everyone whether or not they consider themselves immunocompromised (IC). This can include people who themselves are immunocompromised or who live with someone who is immunocompromised. Allowing people to identify whether or not they consider themselves immunocompromised allows us to create reasonable accommodations for accessing the public sector. Some people cannot mask, and others prefer not to, but we can still allow them to safely access shared spaces if we know how many individuals are truly in need of accommodation.

Those who cannot or prefer not to mask should be free to assess their own risk, especially for a contagion with a 99.6% recovery rate.

If we ask everyone to identify the population they belong to, it all falls into place.

Read the full article on Rational Ground.

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Opinion Videos

Prof Francois Balloux: the climate of fear on Covid is dangerous – UnHerd

Source: UnHerd, 8 Oct 2020
  • Scientists should not be involved in devising and implementing policies.
  • The window of opportunity to suppress the virus is gone.
  • The toll on public health caused by closed borders will be absolutely awful.
  • Indefinite suppression may not have ever been an option.
  • Vaccines may be helpful but won’t be a silver bullet.
  • The virus is here to stay.
  • Vaccines may be effective in reducing symptoms but we can’t gamble on an infection blocking vaccine.
  • Some vaccines aren’t always suitable for the entire population.
  • Banking everything on a vaccine is not a reasonable approach.
  • National level measures are not convincing; targeted measures have more potential.
  • Communication has been problematic so public trust has been lost.
  • Fear over a long period of time is physiologically unhealthy and doesn’t ever just evaporate.
  • The cost of allowing people to choose their own risk-level would be much lower than the current blanket proposals.
  • Well-targeted testing can be extremely effective but mass testing in schools is not a good use of tests.
  • The ‘medicalization’ of society is worrying.
  • Blanket testing of asymptomatic people is completely new and presents multiple ethical problems.
  • Proportion of asymptomatic cases for 2009 influenza pandemic was around 50%-75%; this is similar to what we’re finding COVID-19.
  • COVID-19 is not so different from other viruses but the global approach is completely different.
  • Normalising the mass testing of otherwise healthy testing is very dangerous.
  • There’s not much to be gained from comparing the measures and results between countries; the move to technocracy is dangerous.
  • Whole societies should not turn around public health.
  • A constant climate of fear is counter-productive.
  • There were other countries that took a similar approach to Sweden, such as Switzerland.
  • Past pandemics have been comparable to COVID-19 but did not have the same response.
  • Outbreaks in care homes is nothing new.
  • The pandemic phase of COVID-19 should eventually be over by mid to end of 2021 and in all likelihood become endemic.
  • The most important message: COVID-19 presents a severe health crisis but it is not a ‘new normal.’
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Publications

Global perspective of COVID‐19 epidemiology for a full‐cycle pandemic – Prof. John Ioannidis, Wiley Online Library

  • As of October 2020, there are >1 million documented deaths with COVID‐19.
  • Many early deaths may have been due to suboptimal management, malfunctional health systems, hydroxychloroquine, sending COVID‐19 patients to nursing homes, and nosocomial infections; such deaths are partially avoidable moving forward.
  • About 10% of the global population may be infected by October 2020.
  • Global infection fatality rate is 0.15‐0.20%
  • Global infection fatality rate in those younger than 70 years old is 0.03‐0.04%.
  • Targeted, precise management of the pandemic and avoiding past mistakes would help minimize mortality.

https://onlinelibrary.wiley.com/doi/10.1111/eci.13423

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News

‘Inhumane, degrading, inexplicable’: Britain’s Covid care home policies ‘violated the fundamental human rights of vulnerable elderly residents’, Amnesty International report finds – Daily Mail

  • UK Government’s pandemic policies ‘violated the fundamental human rights of vulnerable older people in care’, Amnesty report claims.
  • Measures exposed elderly residents to Covid then blocked them from care.
  • Ministers ‘know from the outset’ that the virus posed ‘exceptional danger’ to 400,000 residents of UK care homes, many of whom are vulnerable.
  • Care home residents were subjected to ‘inhuman and degrading’ treatment.
  • Report says UK Government is ‘directly responsible’ for the care home tragedy.
  • 8,186 excess deaths recorded in care homes, with 18,562 of these attributed to Covid-19 – 40 per cent of all deaths from the virus.
  • Care home residents with suspected Covid-19 were ‘outright refused’ hospital treatment and died in distress from the virus without appropriate medical care – despite local hospitals having ‘hundreds’ of empty beds;
  • Health chiefs instructed GPs to pressure care home staff to put blanket ‘do not resuscitate’ orders on all residents without discussion. Instructions were often given verbally rather than written – leaving no paper trail;
  • One manager who tried to get a severely unwell resident into hospital in March was told: ‘He’s at the end of his life anyway, so we’re not going to send an ambulance’;
  • Care bosses have continued lockdowns – banning families from visiting loved ones, causing further distress and death – because they feared not following ‘excessive’ Government guidance would lead to them being sued or stripped of their licence to operate;
  • Despite repeated appeals, the Government and public bodies have withheld crucial data about the spread of Covid-19 in care homes and refused to reveal how many key decisions came to be made.

https://www.dailymail.co.uk/health/article-8801287/Coronavirus-UK-Care-home-policies-exposed-residents-virus-BLOCKED-medical-care.html

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News

Councils pay care homes DOUBLE the local weekly fee to take Covid hospital patients amid fears deadly mistakes made at the start of the pandemic will be repeated – Daily Mail

Care home chiefs fear deadly mistakes made at the peak of the coronavirus pandemic risk being repeated as councils offer them extra cash to take Covid-positive hospital patients.

…Now, despite a Government pledge to place a ‘protective ring’ around vulnerable residents, care homes in Cumbria are being offered £1,500 – double the local weekly fee – to take Covid-positive patients from hospital.

…Tony Carling, a care home operator in Cumbria, has decided not to take Covid-positive patients, but fears it could be a costly move. He said: ‘The majority of our clients are funded by local authorities, so it’s very difficult to turn down. You are under extreme financial pressure as to whether you get further business from that authority if you don’t support their needs.’

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Opinion

Boris must urgently rethink his Covid strategy – Professor Carl Heneghan, Professor Karol Sikora, Professor Sunetra Gupta

Dear Prime Minister, Chancellor, CMOs and Chief Scientific Adviser

We are writing with the intention of providing constructive input into the choices with respect to the Covid-19 policy response. We also have several concerns regarding aspects of the existing policy choices that we wish to draw attention to.

In summary, our view is that the existing policy path is inconsistent with the known risk-profile of Covid-19 and should be reconsidered. The unstated objective currently appears to be one of suppression of the virus, until such a time that a vaccine can be deployed. This objective is increasingly unfeasible (notwithstanding our more specific concerns regarding existing policies) and is leading to significant harm across all age groups, which likely offsets any benefits.

Instead, more targeted measures that protect the most vulnerable from Covid, whilst not adversely impacting those not at risk, are more supportable. Given the high proportion of Covid deaths in care homes, these should be a priority. Such targeted measures should be explored as a matter of urgency, as the logical cornerstone of our future strategy.

In addition to this overarching point, we append a set of concerns regarding the existing policy choices, which we hope will be received in the spirit in which they are intended. We are mindful that the current circumstances are challenging, and that all policy decisions are difficult ones. Moreover, many people have sadly lost loved ones to Covid-19 throughout the UK. Nonetheless, the current debate appears unhelpfully polarised around views that Covid is extremely deadly to all (and that large-scale policy interventions are effective); and on the other hand, those who believe Covid poses no risk at all. In light of this, and in order to make choices that increase our prospects of achieving better outcomes in future, we think now is the right time to ‘step back’ and fundamentally reconsider the path forward.

Yours sincerely,

Professor Sunetra Gupta; Professor of theoretical epidemiology, the University of Oxford

Professor Carl Heneghan; Director, Centre for Evidence Based Medicine, the University of Oxford

Professor Karol Sikora; Consultant oncologist and Professor of medicine, University of Buckingham

Sam Williams; Director and co-founder of Economic Insight

https://www.spectator.co.uk/article/boris-needs-to-rethink-his-covid-strategy

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News

Pandemic isolation has killed thousands of Alzheimer’s patients while families watch from afar – The Washington Post

Since the pandemic began, Goerke’s wife, Denise — 63 years old and afflicted with Alzheimer’s disease — had declined dramatically. Left alone in her nursing home, she had lost 16 pounds, could not form the simplest words, no longer responded to the voices of her children.

In recent weeks, she had stopped recognizing even the man she loved.

Goerke, 61, could tell the isolation was killing his wife, and there was nothing he could do but watch. “Every day it gets a little worse,” he said. “We’ve lost months, maybe years of her already.”

https://www.washingtonpost.com/health/2020/09/16/coronavirus-dementia-alzheimers-deaths/

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News

The 1% blunder: How a simple but fatal math mistake by US Covid-19 experts caused the world to panic and order lockdowns – Dr. Malcolm Kendrick, RT

But where did this one percent figure come from? You may find this hard to believe, but this figure emerged by mistake. A pretty major thing to make a mistake about, but that’s what happened.

In order to understand what happened, you have to understand the difference between two medical terms that sound the same – but are completely different. [IFR and CFR.]

CFR will always be far higher than the IFR. With influenza, the CFR is around ten times as high as the IFR. Covid seems to have a similar proportion.

Now, clearly, you do not want to get these figures mixed up. By doing so you would either wildly overestimate, or wildly underestimate, the impact of Covid. But mix these figures up, they did.

…we’ve had all the deaths we were ever going to get. And which also means that lockdown achieved, almost precisely nothing with regard to Covid. No deaths were prevented.

https://www.rt.com/op-ed/500000-covid19-math-mistake-panic/

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News Opinion

UK lockdown was a ‘monumental mistake’ and must not happen again – The Express

LOCKDOWN will come to be seen as a “monumental mistake on a global scale” and must never happen again, a scientist who advises the Government on infectious diseases says.

Mark Woolhouse said lockdown was a “panic measure” but admitted it was the only option at the time because “we couldn’t think of anything better to do”.

But it is a crude measure that takes no accounts of the risk levels to different individuals, the University of Edinburgh professor said, meaning that back in March the nation was “concentrating on schools when we should have been concentrating on care homes”.

https://www.express.co.uk/life-style/health/1320428/Coronavirus-news-lockdown-mistake-second-wave-Boris-Johnson

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News

Care homes ‘ordered not to resuscitate’ as coronavirus pandemic took hold – The Times

Care homes were asked to introduce blanket “do not resuscitate” orders for all residents at the height of the coronavirus pandemic, it has been claimed.

The Queen’s Nursing Institute (QNI), a charity promoting community nursing, found that one in ten care homes were ordered to introduce the measure without discussion with staff, family members or the residents. It was intended to help keep hospital beds free.

Half of staff members who said that they had been asked to change DNRs worked in homes for people with learning or cognitive disabilities. The other half worked in homes for the elderly.

Alison Leary, professor of healthcare and workforce modelling at London South Bank University and the author of the report, described the findings as worrying…

https://www.thetimes.co.uk/article/care-homes-ordered-not-to-resuscitate-as-coronavirus-pandemic-took-hold-3gsslg6jt

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News

Restrictions have turned care homes into ‘prisons’, charities warn Government – The Telegraph

Care homes have been turned into prisons, with residents “losing the will to live” as they are deprived contact with families, charities for the elderly have warned.

The All-Party Parliamentary Group on coronavirus was told that restrictions on visiting homes have become so extreme that vulnerable people are being left distressed and lonely, in some cases unable to recognise their loved ones.

Charities said belated attempts to keep residents safe from the spread of coronavirus were too often creating misery and isolation.

They criticised the Government for acting so slowly to attempt to protect care homes from the pandemic that 6,000 deaths had occurred by the time testing was introduced.

https://www.telegraph.co.uk/news/2020/08/12/restrictions-have-turned-care-homes-prisons-charities-warn-government/

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News

Sedation to manage ‘lockdown distress’ may have led to dementia deaths – Glasgow Times

A RISE in the use of sedation to manage ‘lockdown distress’ amongst the elderly may have contributed to a stark increase in dementia death rates, a charity has warned.

Figures show in all the deaths involving Covid-19 between March and June 2020, 92% had at least one pre-existing condition with dementia accounting for almost a third.

https://www.glasgowtimes.co.uk/news/18590724.sedation-manage-lockdown-distress-may-led-dementia-deaths/

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News

Revealed – 16 care homes given £1,000 to take Covid-positive hospital patients – Birmingham Mail

  • From late-February 2020, Birmingham City Council gave care homes a £1,000 extra cash to take in hospital patients in a hurry, including some with coronavirus.
  • Reason: more NHS beds could be freed up for coronavirus patients.
  • Care home had to bid for the resident in a four hour window and, if their bid was ‘winning’, organise admission within 24 hours – regardless of the citizen’s Covid-19 testing or diagnosis status at the point of discharge.
  • Care home manager, Jane Farr, of Digby Manor care home in Erdington, believes her rejection of the offer is one of the reasons none of her residents have been infected.
  • From late February, any in-patients deemed ‘fit to discharge’ were rapidly moved out of hospital so hospital staff could focus on coronavirus patients.
  • Dr David Rosser, chief executive of University Hospitals Birmingham (UHB) said the city created too much capacity – indicating some of the frantic measures to empty beds turned out to be not needed.
  • From April 15 the Government’s rules changed and all discharged residents were supposed to undergo a test first.

https://www.birminghammail.co.uk/news/midlands-news/revealed-16-care-homes-given-18550503

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Visitor Contributions

Covid 19 X-Factor in Spain – Nursing Homes: UNDERSTANDING WHAT REALLY HAPPENED

In the interest of public debate, we allow visitors to share opinions, experiences and research that may be of value to others. This is a visitor contribution from our Discussions page.

The views expressed are those of the individual posters themselves. Please read our Comments and contributions disclaimer.

Author

Alfonso Longo


Covid 19 X-Factor in Spain – Nursing Homes: UNDERSTANDING WHAT REALLY HAPPENED

Hypothesis

The nursing homes, their structure and management, explain the impact of the covid-19 pandemic in Spain.

DIRECTLY: because of the weight of its mortality

CAUSALLY: because of its effect on the transmission of the virus to the rest of the population

Therefore, in order to minimize the impact of covid on society, its impact on nursing homes must first be minimized.

Download the document here.

(Note that the document is hosted on Google Drive.)

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Videos

T-cell immunity and the truth about Covid-19 in Sweden – Dr. Soo Aleman, UnHerd

“Intensive care units are getting empty, the wards are getting empty, we are really seeing a decrease — and that despite that people are really loosening up. The beaches are crowded, social distancing is not kept very well … but still the numbers are really decreasing. That means that something else is happening – we are actually getting closer to herd immunity. I can’t really see another reason.”

“I can’t say if the Swedish approach was right or wrong – I think we can say that in one or two years when we are looking back. You have to look at the mortality over the whole period.”

“I don’t think that we have more new cases, I think we are just detecting more cases”

“We found that if you have a mild case you can be negative for antibodies afterwards … in those almost all of them had strong T-cell activity. This study says that there are cases that you can have a strong T-cell response even though you have not had antibodies, meaning that you have encountered the virus and built up immunity.”

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Publications

80.9% of care home residents who tested positive were asymptomatic – Department of Health & Social Care

  • 2.4% of all tests were positive (9,674 out of 397,197)
  • 3.9% of residents tested positive (6,747 out of 172,066)
  • 3.3% of asymptomatic residents tested positive (5,455 out of 163,945)
  • 80.9% of residents who tested positive were asymptomatic (5,455 out of 6,747)
  • 1.2% of asymptomatic staff tested positive (2,567 out of 210,620)

https://www.gov.uk/government/publications/vivaldi-1-coronavirus-covid-19-care-homes-study-report/vivaldi-1-covid-19-care-homes-study-report

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Videos

Alistair Haimes – on being a lockdown sceptic – Freethinking with Laura Dodsworth

Laura Dodsworth interviews Alistair Haimes on Freethinking with Laura Dodsworth.

Support Laura Dodsworth through Patreon:
https://www.patreon.com/lauradodsworth

Interview notes and charts

  • The difference between what the government was telling us and what their information was telling us was so extreme and outrageous.
  • Exponential means a “constant rate of growth.” The government data in March was clearly showing that the COVID-19 was declining, not growing exponentially. This was the same in all countries you could see the data. [See chart 1]
  • A constantly declining growth rate will make a bell curve. The government were standing in front of bell curve graphs during their briefings yet they were telling us we were in the middle of the epidemic.
  • It was very clear that we were heading to a peak sometime around early to mid-April.
  • You don’t have to be complicated mathematics to see that COVID-19 was running out of steam almost from day one.
  • The conclusion from the Centre for Evidence-Based Medicine seems to be that it’s impossible to predict if there will be a second wave.
  • Sweden’s epidemic looks identical to the UK’s but they did not lockdown. Their datapoint indicates there won’t be a second wave. There has been no spike in Denmark either. [See chart 2]
  • Unknowns: has summer affected COVID-19 and will there be a mutation?
  • Will illnesses during the autumn and winter be mis-attributed to COVID-19? Poor media coverage means that we can’t be sure.
  • Symptoms of COVID-19 are very similar to the flu. Something could look like a second wave but will we really know?
  • The lockdown is costing a Brexit bill a week.
  • The government response seems to have been skewed by Neil Ferguson’s modelling data. The make-up of government advisors seems to be a recipe for groupthink, which is very dangerous.
  • Epidemiology (the way a disease spreads through the population) is not complicated science. The government could have had lots of people who were very good at this but they didn’t.
  • We should have cocooned the vulnerable, make sure the NHS has capacity and “let it rip” through the population.
  • We should never have had an open-ended lockdown.
  • The ‘R number’ is just the difference of in the number of people infected after each generation of a disease. Britain crossed the ‘magical R of 1’ line a few days before lockdown and the same day as Sweden. Whatever interventions have been done doesn’t seem to have had any effect. [See chart 3]
  • COVID-19 is mostly a care home and hospital disease. This was obvious very early on. Old people should not have been moved from hospitals into care homes. It seems as if we knowingly seeded the most vulnerable environment with the disease.
  • 37% of our deaths are care home residents but they are only 0.5% of our population. Of them are dementia sufferers.
  • Over 20% of the infections were picked up in the hospitals. COVID-19 seems more like MRSA than influenza in that it’s an infection control problem.
  • COVID-19 is much more comparable to flu for the rest of the population.
  • 1968 flu killed 80,000 people in the UK.
  • This last winter was a low flu winter. It’s quite possible that the people who died of COVID-19 are those who didn’t die.
  • If you overlay COVID-19 deaths with the 2000 flu season, they look very similar. [See chart 4]
  • 95% of deaths have had another serious disease. Most people have almost no chance of dying from COVID-19.
  • If you are under 40, you have more chance of being struck by lightning that dying of COVID-19.
  • If you are under 60, you have more chance of drowning.
  • At any age, you have more chance of dying on the roads than dying of COVID-19.
  • Lead indicators of 111 and 999 calls with COVID-19 symptoms show there was no spike after VE Day celebrations or BLM protests. In fact, it was even coming down at lockdown. That lockdown was big change for COVID-19 is invisible in the data. [See chart 5]
Charts

Chart 1: COVID-19 was declining in Europe as of march. It was not growing exponentially

Heading to zero? @AlistairHaimes, 29 March 2020

Chart 2: Sweden’s epidemic looks similar to the UK’s but they did not lock down.

Sweden has had fewer covid deaths per capita than Belgium, Spain, Italy or the UK, and its children <16 have missed no school. @AlistairHaimes, 17 June 2020

Chart 3: Britain crossed the ‘magical R of 1’ line a few days before lockdown

UK Rt (“R number”), late Feb to early April. Lockdown did the square root of nothing. Hand-washing advice early March does look to have caused a massive drop in R, as you’d expect. @AlistairHaimes, 5 May 2020

Chart 4: COVID-19 deaths overlayed with the 2000 flu season

If covid deaths had happened in winter rather than spring. Shown against two recent moderately bad influenza years, for comparison. @AlistairHaimes, 23 June 2020

Chart 5: No spike after BLM protests

No uptick in covid cases following the BLM protests. @AlistairHaimes, 22 June 2020
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News

25,000 people discharged from hospitals to care homes before government started routine testing – PoliticsHome

A new report by the National Audit Office confirms that 25,000 people moved from hospitals into care homes between mid-March and mid-April.

Jeremy Hunt, the Conservative former health secretary who now chairs the Commons Health Committee, said the findings were “extraordinary” and came “despite widespread knowledge that the virus could be carried asymptomatically”.

https://www.politicshome.com/news/article/coronavirus-25000-people-discharged-from-hospitals-to-care-homes-without-tests-at-height-of-pandemic-watchdog-confirms

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News

Dying of neglect: the other Covid care home scandal – The Spectator

It is remarkable how many deaths during this pandemic have occurred in care homes. According to the Office for National Statistics, nearly 50,000 care home deaths were registered in the 11 weeks up to 22 May in England and Wales — 25,000 more than you would expect at this time of the year. Two out of five care homes in England have had a coronavirus outbreak; in the north-east, it’s half.

Not all these deaths, however, have been attributed to Covid-19. Even when death certificates do mention it, it is not always clear that it is the disease that was the ultimate cause of death. The data refers to people who died with Covid-19 present in their bodies, whether or not it was the direct cause. This raises questions about whether there’s another reason for many of these deaths which has gone largely unnoticed while attention has been focused on Covid-19. This is not just a British phenomenon, but one seen across Europe.

https://www.spectator.co.uk/article/dying-of-neglect-the-other-covid-care-home-scandal

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News

Calls to lift lockdown in UK care homes over fears for residents’ mental health – The Guardian

Senior social care leaders are calling on ministers to prioritise unlocking care homes amid growing concerns that mental health problems are contributing to the deaths of residents.

https://www.theguardian.com/society/2020/may/30/calls-to-lift-lockdown-in-uk-care-homes-over-fears-for-residents-mental-health