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News

Covid wards empty as virus death toll plunges – The Times

Fatalities are down 99% and some hospitals have no coronavirus patients, sparking hope that ‘herd immunity’ may be near

The number of people in hospital with Covid-19 has fallen 96% since the peak of the pandemic, official data reveals.

Hospital staff are now treating just 700 coronavirus patients a day in England, compared to about 17,000 a day during the middle of April, according to NHS England.

Last week, some hospitals did not have a single coronavirus patient on their wards, with one top doctor suggesting that Britain is “almost reaching herd immunity”.

https://www.thetimes.co.uk/article/covid-wards-empty-as-virus-death-toll-plunges-bvm0mxl2n

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News

NHS hospitals are warned they will face a fine if they are not at 90% of their usual capacity levels by October – Daily Mail

NHS hospitals have been warned they could face a fine if they are not at 90 per cent of their usual capacity levels by October.

A lot of routine care was paused due to the coronavirus pandemic and hospitals are currently thought to be running around 60 per cent of their usual capacity. 

https://www.dailymail.co.uk/news/article-8582991/NHS-hospitals-warned-face-fine-not-90-usual-capacity-levels-October.html

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News

Government urged to focus on surge in unexplained non-Covid deaths at home – The Telegraph

Experts fear people still unable to access medical care even though there are now relatively few coronavirus cases in hospitals

Twice as many people are now dying at home from unexplained causes rather than Covid-19, with experts calling for an urgent investigation into what is causing the excess deaths.

The ONS figures show that deaths in hospitals continue to be much lower than usual, suggesting that many of the home deaths are people who would ordinarily have received hospital care.

https://www.telegraph.co.uk/news/2020/07/28/deaths-home-causes-coronavirus-increase-ons-figures-reveal/

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Videos

Oxford epidemiologists: suppression strategy is not viable – UnHerd

2:55 – Masks
• Tom Jefferson: “Aside from people who are exposed on the frontlines, there is no evidence that masks make any difference, but what’s even more extraordinary is the uncertainty: we don’t know if these things make any difference…. We should have done randomised control trials in February, March and April but not anymore because viral circulation is low and we will need huge number of enrolees to show whether there was any difference”.
• Carl Heneghan: “By all means people can wear masks but they can’t say it’s an evidence-based decision… there is a real separation between an evidence-based decision and the opaque term that ‘we are being led by the science’, which isn’t the evidence”.

9:26 – Pandemic life cycle
• CH: “One of the keys of the infection is to look at who’s been infected, which shows a crucial difference when comparing the pandemic theory to seasonal theory. In a pandemic you’d expect to see young people disproportionately affected, but in the UK we’ve only had six child deaths, which is far less than we’d normally see in a pandemic. The high number of deaths with over-75s fits with the seasonal theory”.

14:00 – Covid seasonality
• CH: “The stability of the virus is far less when the temperature goes up but humidity seems to be particularly important. The lower the humidity, the more stable the virus is in the atmosphere and on surfaces… It’s now winter in the southern hemisphere, which is why places like Australia are suddenly having outbreaks.”

20:37 – Lockdown
• CH: “Many people said that we should have locked down earlier, but 50% of care homes developed outbreaks during the lockdown period so there are issues within the transmission of this virus that are not clear… Lockdown is a blunt tool and there needs to be intelligent conversations about what mitigation strategies can keep society functioning while we keep the most vulnerable shielded”.

25:20 – Nightingale hospitals
• CH: “They are the wrong structure. What you need is fever hospitals which were here until around the 1980s or 90s. They were on single floors and had isolation within isolation. Theere were no lift shafts and staff were trained, which meant that everyone was protected from each other… It looks like at leats 20% of people got the infection while they were in hospital”

27:30 – Suppression strategy
• CH: “The benefits of the current strategy are outweighed by the harms…When it comes to suppression, only the virus will have a determination in that. If you follow the New Zealand policy of suppressing it to zero and locking down the country forever, then you’re going to have a problem… This virus is so out there now, I cannot see a strategy that makes suppression the viable option. The strategy right now should be how we learn to live with this virus”

32:45 – Response to the virus
• TJ: “I am a survivor of four pandemics and for the other three, I didn’t even realise they were going on. People died but nothing changed and none of the fabric of society was eroded like this response… Do I see steps being taken at a European level about learning from our mistakes and changing policies? The answer is no…

39:30 – Politics of the virus
• CH: “We as individuals are part of the problem because sensationalism drives people to click and read the information. So it’s a big circle because we’ve created the problem — if we put the worst case scenario out there, we will go and have a look. If you want a solution, you’ve got to get people to stop clicking on this sensationalist stuff”.

43:30 – IFR
• CH: “We will be down about where we were with the swine flu: around 0.1-0.3% which is much lower than what we think because at the moment we are seeing the case fatality”.
• TJ: “If you look at the whole narrative, it was distorted from the very beginning by the obsession with influenza which was just one or two agents and nothing else existed. We’re no different now”.

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News

People with treatable cancers will die due to Government scaremongering, warns NHS nurse – The Telegraph

People with treatable cancers are going to die because hospitals have been laid empty due to Government scaremongering, an NHS nurse has warned.

An NHS nurse called Holly* has said that throughout the lockdown period “hospitals were empty” beyond the ICU units and Covid wards and that people have died as a result. 

https://www.telegraph.co.uk/news/2020/07/23/people-treatable-cancers-will-die-due-government-scaremongering/

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News

Coronavirus pandemic already in retreat before lockdown – Chris Whitty, The Times

The coronavirus pandemic was probably already in retreat before the full lockdown was imposed, the chief medical officer for England said as he insisted that there was no “huge delay” in government action.

Chris Whitty said that “many of the problems we had came out of lack of testing capacity”. He blamed a failure to build up public health infrastructure in previous years for leaving Britain unprepared.

Chris Whitty blames poor planning for lockdown in bad-tempered health committee – The Times, 22 July 2020

https://www.thetimes.co.uk/article/chris-whitty-blames-poor-planning-for-lockdown-in-bad-tempered-health-committee-d5kb3fmw2

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News

Lockdown may cost 200,000 lives, government report shows – The Telegraph

As national restrictions were imposed, experts from the Department of Health, the Office of National Statistics (ONS), the government’s Actuary Department and the Home Office forecast the collateral damage from delays to healthcare and the effects of recession arising from the pandemic response.

It estimated that in a reasonable worst case scenario, around 50,000 people would die from coronavirus in the first six months of the pandemic, with mitigation measures in place.

[T]he report published in April they calculated that up to 25,000 could die from delays to treatment in the same period and a further 185,000 in the medium to long term – amounting to nearly one million years of life lost.

https://www.telegraph.co.uk/news/2020/07/19/lockdown-may-cost-200k-lives-government-report-shows/

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Publications

Limited evidence regarding the respiratory protection using non-medical / homemade masks – SAGE

SARS-CoV-2 in the hospital environment and risk of COVID-19 nosocomial transmission

A document produced by SAGE states the following.

Evidence on efficacy of cloth face-coverings (non-medical masks):

There is limited evidence regarding the respiratory protection that non-medical / homemade masks can offer for the wearer, and there are no established quality standards for self-made face masks. One study reported a low filter efficiency (3-33%), and high penetration (up to 97%) of NaCl aerosol particles in homemade masks (42). A trial comparing the use of cloth and medical masks by healthcare workers also showed penetration of microorganisms by 97%, compared with a rate of 44% for medical masks (43).

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/895818/S0485_EMG_SARS-CoV-2_in_the_hospital_environment.pdf

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Publications

Contamination by respiratory viruses on outer surface of medical masks used by hospital healthcare workers – BMC Infectious Diseases

Background
Medical masks are commonly used in health care settings to protect healthcare workers (HCWs) from respiratory and other infections. Airborne respiratory pathogens may settle on the surface of used masks layers, resulting in contamination. The main aim of this study was to study the presence of viruses on the surface of medical masks.

Methods
Two pilot studies in laboratory and clinical settings were carried out to determine the areas of masks likely to contain maximum viral particles. A laboratory study using a mannequin and fluorescent spray showed maximum particles concentrated on upper right, middle and left sections of the medical masks. These findings were confirmed through a small clinical study. The main study was then conducted in high-risk wards of three selected hospitals in Beijing China. Participants (n = 148) were asked to wear medical masks for a shift (6–8 h) or as long as they could tolerate. Used samples of medical masks were tested for presence of respiratory viruses in upper sections of the medical masks, in line with the pilot studies.

Results
Overall virus positivity rate was 10.1% (15/148). Commonly isolated viruses from masks samples were adenovirus (n = 7), bocavirus (n = 2), respiratory syncytial virus (n = 2) and influenza virus (n = 2). Virus positivity was significantly higher in masks samples worn for > 6 h (14.1%, 14/99 versus 1.2%, 1/49, OR 7.9, 95% CI 1.01–61.99) and in samples used by participants who examined > 25 patients per day (16.9%, 12/71 versus 3.9%, 3/77, OR 5.02, 95% CI 1.35–18.60). Most of the participants (83.8%, 124/148) reported at least one problem associated with mask use. Commonly reported problems were pressure on face (16.9%, 25/148), breathing difficulty (12.2%, 18/148), discomfort (9.5% 14/148), trouble communicating with the patient (7.4%, 11/148) and headache (6.1%, 9/148).

Conclusion
Respiratory pathogens on the outer surface of the used medical masks may result in self-contamination. The risk is higher with longer duration of mask use (> 6 h) and with higher rates of clinical contact. Protocols on duration of mask use should specify a maximum time of continuous use, and should consider guidance in high contact settings. Viruses were isolated from the upper sections of around 10% samples, but other sections of masks may also be contaminated. HCWs should be aware of these risks in order to protect themselves and people around them.

https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4109-x

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Videos

Perspectives on the Pandemic | The (Undercover) Epicenter Nurse | Episode Nine

  • Non-COVID patients were put in with COVID patients, then marked with Do Not Resuscitate orders.
  • Hospitals have a financial incentive to mark patients as COVID-19.
  • Doctors stopped treating people as humans. Inexperienced doctors were practicing on patients.
  • COVID-19 has been proven to be easily treatable with the Hydroxychloroquine/Zinc/Antibiotic protocol
  • People were coming in too late due to fear.
  • Patients were unnecessarily put on ventilators. “They want to use the vents.”
  • Patients were put in restraints “due to laziness.”
  • New York may have been hit hard because their hospitals were already struggling. They couldn’t afford to keep them open.

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News

600 Physicians Say Lockdowns Are A ‘Mass Casualty Incident’ – Forbes

More than 600 of the nation’s physicians sent a letter to President Trump this week calling the coronavirus shutdowns a “mass casualty incident” with “exponentially growing negative health consequences” to millions of non COVID patients. 

  • This is an order of magnitude error.
  • Suicide hotline phone calls have increased 600%.
  • Patients fearful of visiting hospitals and doctors’ offices are dying because COVID-phobia is keeping them from seeking care.
  • Restrictions are having a huge negative impact on non-COVID patients.
  • Zero  cases of COVID-19 are prevented by new practices.
  • Patients still are fearful about going to hospitals for heart attacks and even for broken bones and deep lacerations.

https://www.forbes.com/sites/gracemarieturner/2020/05/22/600-physicians-say-lockdowns-are-a-mass-casualty-incident/

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Publications

Covid-19: Doctors sound alarm over hospital transmissions – BMJ

Doctors have told The BMJ they are deeply concerned at the number of patients becoming infected with covid-19 in NHS hospitals in England and have called for more stringent infection control measures to combat its spread.

https://www.bmj.com/content/369/bmj.m2013

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News

Up to 20% of hospital patients with Covid-19 caught it at hospital – The Guardian

NHS England figures reveal some infections were passed on by hospital staff unaware they had virus.

Up to a fifth of patients with Covid-19 in several hospitals contracted the disease over the course of the pandemic while already being treated there for another illness, NHS bosses have told senior doctors and nurses.

https://www.theguardian.com/world/2020/may/17/hospital-patients-england-coronavirus-covid-19

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News

Diabetics make up a third of England’s Covid hospital deaths – The Telegraph

Experts said the major study, which included all patients hospitalised with Covid-19 over 10 weeks, showed that diabetes – which is often fuelled by obesity – is driving Britain’s death toll.

https://www.telegraph.co.uk/news/2020/05/19/one-third-covid-19-deaths-england-have-among-diabetics/

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Opinion

Can we trust Covid modelling? More evidence from Sweden – The Spectator

One reason why the models failed is that they – just like most countries’ politicians – underestimated how millions of people spontaneously adapt to new circumstances. They only thought in terms of lockdowns vs business as usual, but failed to consider a third option: that people engage in social distancing voluntarily when they realise lives are at stake and when authorities recommend them to do so.

As countries plan how to leave lockdown, they can look at Sweden and ask: what happens if you don’t involve the police, if you don’t issue edicts about how many of your relatives or neighbours you can visit, and just ask people to be careful? Might that work? The Swedish experiment casts huge doubts on the models, and makes the case for trusting the public.

https://www.spectator.co.uk/article/can-we-trust-covid-modelling-more-evidence-from-sweden

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Videos

Covid-19 – Britain’s Disastrous Response Will Have Devastating Consequences – David Starkey

What is unique about this pandemic–apart from the fact that it’s rather small–is that the damage that it does is self-inflicted.

This is a very odd plague. It’s rather small in scale but it’s gigantic in consequences because we have chosen to inflict a form of economic suicide on ourselves.

This week on “So What You’re Saying Is…”: Dr. David Starkey argues that a calamitous series of events and decisions caused a panicked British government to recklessly abandon its sensible coronavirus plan for one that is likely to harm the nation far more than the virus itself.

Comparing this virus with historical pandemics Starkey believes the dire situation we are encountering today has a different cause. Earlier pandemics such as the Black Death eradicated up to half of the population of Europe. In contrast, although it is profoundly tragic on a personal level to the individuals and familiies it afflicts, coronavirus is nowhere near as devastating on a population-wide level as previous pandemics. Consequently, Starkey argues, the Conservative government was correct to follow a similar path to Sweden which was far more relaxed than elsewhere in Europe.

This approach suited Prime Minister Boris Johnson’s libertarian attitude and personality. But on a single weekend there was a calamitous confluence of events and decisions that caused the Tory government to panic (Northwick Park hospital overwhelmed, Imperial College modelling showing potential 500,00 deaths etc.) and enforce an extreme lockdown without any plan to deal with the epidemic. It was simply a goal to protect the NHS.

Protect the NHS: The Tory Government, says Dr. Starkey, was desperate not to be seen as responsible or the NHS being overwhelmed. Eager to prove to the traditional Labour “Red Wall” that the Conservative Party really was their natural home, the British government prioritised the NHS’s capacity to deal with Covid-19 over everything else– but disastrously this included its treatment of cancer patients etc. A bizarre and unprecdented abandoning of the Hippocratic oath that we have not seen in other countries, argues Starkey.

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Opinion

How to make a crisis far, far, worse – Dr. Malcolm Kendrick

The main thing that went wrong, I believe, was a failure to understand that hospitals would become the vectors for COVID, the epicentres for the infection. We – the hospitals, the decisions taken by the NHS managers with their clipboards – spread the disease, especially among the elderly vulnerable in care homes. A disease that we were trying to stop… killing the elderly and vulnerable.

https://www.rt.com/op-ed/488075-nhs-made-covid-19-crisis-worse/

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Publications

Surgical Mask vs N95 Respirator for Preventing Influenza Among Health Care Workers – JAMA (2009)

Surgical masks and N95 respirators are not effective at preventing the flu. Of the 446 nurses who took part in this study, nearly one in four (24%) in the surgical mask group still got the flu as did 23% of those who wore the N95 respirator.

Influenza infection occurred in 50 nurses (23.6%) in the surgical mask group and in 48 (22.9%) in the N95 respirator group (absolute risk difference, −0.73%; 95% CI, −8.8% to 7.3%; P = .86), the lower confidence limit being inside the noninferiority limit of −9%.

https://jamanetwork.com/journals/jama/fullarticle/184819

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Opinion

Alistair Haimes: The virus that turned up late

“There are really only two particularly unusual things about the Covid-19 epidemic: the timing of its arrival and the lockdown some countries declared.”

Deaths per day, as is well-reported, peaked around Easter; and because deaths lag infections by something around three weeks, this implies that infections peaked sometime in mid-March. If you add up all the bars in the chart and fill in the blank area of deaths still to come, we are looking at a killer that, in scale, is bad-but-nothing-special compared to killers of previous years. Panning out: as a killer worldwide, it looks as though Covid is going to take a toll perhaps 1% of 1918’s Spanish Flu.

…the dark blue line is 2019-20, with Covid-19; the turquoise and red lines are the bad flu years of 1998-99 and 1999-2000.

…Covid-19 is narrowly in third place as a killer to remember, behind the 1998-99 and 1999-2000 influenzas (2017-18’s ‘Beast from the East’, the green line, doesn’t place), a point also made by American statistician William Briggs.

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Publications

Healthcare personnel exposure in an emergency department during influenza season – PubMed (2018)

Abstract

Introduction: Healthcare personnel are at high risk for exposure to influenza by direct and indirect contact, droplets and aerosols, and by aerosol generating procedures. Information on air and surface influenza contamination is needed to assist in developing guidance for proper prevention and control strategies. To understand the vulnerabilities of healthcare personnel, we measured influenza in the breathing zone of healthcare personnel, in air and on surfaces within a healthcare setting, and on filtering facepiece respirators worn by healthcare personnel when conducting patient care.

Methods: Thirty participants were recruited from an adult emergency department during the 2015 influenza season. Participants wore personal bioaerosol samplers for six hours of their work shift, submitted used filtering facepiece respirators and medical masks and completed questionnaires to assess frequency and types of interactions with potentially infected patients. Room air samples were collected using bioaerosol samplers, and surface swabs were collected from high-contact surfaces within the adult emergency department. Personal and room bioaerosol samples, surface swabs, and filtering facepiece respirators were analyzed for influenza A by polymerase chain reaction.

Methods: Thirty participants were recruited from an adult emergency department during the 2015 influenza season. Participants wore personal bioaerosol samplers for six hours of their work shift, submitted used filtering facepiece respirators and medical masks and completed questionnaires to assess frequency and types of interactions with potentially infected patients. Room air samples were collected using bioaerosol samplers, and surface swabs were collected from high-contact surfaces within the adult emergency department. Personal and room bioaerosol samples, surface swabs, and filtering facepiece respirators were analyzed for influenza A by polymerase chain reaction.

Conclusions: Healthcare personnel may encounter increased concentrations of influenza virus when in close proximity to patients. Occupations that require contact with patients are at an increased risk for influenza exposure, which may occur throughout the influenza season. Filtering facepiece respirators may become contaminated with influenza when used during patient care.

https://pubmed.ncbi.nlm.nih.gov/30169507/