Originally posted by AtW
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PM: real tough measures
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“The period of the disintegration of the European Union has begun. And the first vessel to have departed is Britain” -
minestrone that's greatly exaggerated; and, in my view, turning apples into oranges.
It is fair to say in defense of the UK's response , that China has more experience dealing with this, but they did not make just 1000 beds in 10 days and beds don't mean beds they mean beds and staff. China also has SARS experience and old SARS hospitals.
Nightingale has 500 beds, with staff earmarked for that. They have 'capacity' (space wise) for 3500 more and 2 morgue wings; but we don't have staff , or the equipment for that , unless we start using retired , or volunteers, which is where we are going.
NIghtingale though, is for overspill from ICU and will undoubtedly be grim. China's 'makeshift hospitals' were 'Isolation facilities' not (primarily) ICU facilities.
China built and staffed 2000+ beds with post SARS trained , specialist doctors in 10 days. We are not matching that at all, and its a falsehood to say so.
<this bit is nicked from an old conv>
The government commandeered 24 hospitals in Wuhan solely for the Corona Virus, and built 2. So at your bed sizes quoted above I’d say they want about 50,000 beds
</snip>
Interestingly, these staff are now over in the EU (I think mainly in Italy) and have had NO time off since January.
Finally, Wuhan made 20x nightingales (if we are going to count turning arenas into hospitals, like we did). This combined with the hospitals made over 29000 ICU beds. We simply can't compete with that. It's harrowing to add, that people also died because even that wasn't enough.
I'm not taking sides here though, because China is not a free society and has economies of scale and central planning we do not. But to say that we've performed quicker, better, or in any way comparable to an economic powerhouse like China is , for me, a bit too much.
Wuhan 18th Feb:
Last edited by Scoobos; 29 March 2020, 15:13.Comment
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Originally posted by Scoobos View PostNightingale has 500 beds, with staff earmarked for that. They have 'capacity' (space wise) for 3500 more and 2 morgue wings; but we don't have staff , or the equipment for that , unless we start using retired , or volunteers, which is where we are going.
NIghtingale though, is for overspill from ICU and will undoubtedly be grim. China's 'makeshift hospitals' were 'Isolation facilities' not (primarily) ICU facilities.
t was all framed as if there would be a cavalry coming of newly up-skilled doctors, doctors from other regions, those out of retirement to staff it. But it is becoming more clear there is not a cavalry but just more space for us to spread into, but with the same number of staff.”
The more I see official policies and documents for it I know every single name on a document or email ... We have a world leading network of critical care in London and it is the same names and faces who, in addition to running their own hospitals at surge capacity, are also expecting to provide cover equipment and staff to Excel.
We need to be clear that this is not something that is coming to save London hospitals. This is a sign we will have to surge past any surge done so far.
...
One of the issues is medical wards are now all full of covid patients who don’t need intensive care so we cannot step down patients to medical wards as they are near surge capacity too.
At what level do you want surge capacity for extra beds - do you want them to be intubated intensive care beds? Or people who are on a tiny bit of oxygen? Do you want it to be for patients who have appendicitis who happen to get sick during all of this?
There will be criteria for getting into the Nightingale but think it will be more about whether you are safe to be at a facility that does not have the depth of specialty backup.
At first the Nightingale felt like a great idea as though a bunch of people would come to run it but now we have realised it is robbing Peter to pay Paul and it felt more like a publicity stunt. As they have been filling in the Nightingale and more concrete plans are coming out ... we are seeing leadership consultants we really admire moving over there and everyone is starting to realise there is not a cavalry we are the same team and stretch to cover this but maybe that is good and mean safer care across London.
“Brexit is having a wee in the middle of the room at a house party because nobody is talking to you, and then complaining about the smell.”Comment
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Again , it's heresay as a 'man on the web' but there are staff for 500 beds there, that know what they are doing. (or at least that was the 'official line' on Friday, it may as above, be crap!)
But yeah, I've also heard a lot of complaints, that everyone's been asked to do covid-19 stuff within the 'normal' hospitals, that aren't trained or specialised in anything to do with it. There's a lot on the BBC too saying this, a paediatrician today saying shes getting asked.
An intereresting thing from your quote is :
"One of the issues is medical wards are now all full of covid patients who don’t need intensive care so we cannot step down patients to medical wards as they are near surge capacity too."
This is what china built extra capacity for, and isolated these people. the numbers are incredible though, and I suspect along with many others, that China's figures are probably like ours fudged, whilst we use only hospital admissions, maybe china used only ICU or something, cos 50k - 29k ICU means 31k beds for people who don't need intensive care, but do need oxygen and monitoring. I think the 'accepted' (if there can be such a thing) figures at the moment are 80% can self manage, 20% hospitalisation, 8-10% icu, 3% death. (with capacity in health care, obviously)
What I'm not seeing a lot of though, are firm figures on 'recovery' from anywhere other than China, which is both dubious and re-assuring at the same time. 76k recovered, 82k total, 3.3k dead - since Jan.
If this truely is 14 days max - then the recovered stat doesn't work.. What also does my head in, is how people think hospitalisation is an OK outcome, its not, its really not where you want to be with Covid. Its not nice for anyone . We tend to focus on stats and death to make ourselves feel better or downplay severity (it's only 3% mortality, or I want there to be a vent there if I need one). No you don't, being on a vent is being on life support. Buying vents is, for me, not a great place to be in, over just locking down properly.
With planes coming in from hotspots with no quarantine, underground transport running and accessible to the general public and NON key workers travelling, we are going to suffer until we stop messing about .Last edited by Scoobos; 29 March 2020, 15:48.Comment
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Originally posted by Scoobos View PostI'm with you AtW on a lot of points, but Wuhan is not open. It's in the process of gently 'opening', the buildings that were welded, still are, and workplaces are not open. It's a go out and have a walk instruction to a subset of the city. (AFAIK, just from reading the news)
Would they have done it if they did not feel confident situation under control?
Obviously not, they are also smart about doing it slowly, where as we are stuck at home - it’s more liberal in China nowComment
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Originally posted by shaunbhoy View PostHe should just have followed your lead and run away from anything that he is scared of.
The reason we are in deep tulip now is cretins like yourselfComment
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Originally posted by AtW View PostWow he wrote a letter, that will show the virus
I am what I drink, and I'm a bitter manComment
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