Actual, you know, ignorance

We really shouldn’t allow people like this anywhere near the formulation of public policy:

Deaths are down. That’s good.

But the fall is most heavily in hospital (22%). At home it is 12% and in care homes 19%.

The NHS is being protected but people are dying elsewhere instead.

And that does not look like a healthcare policy to me.

The entire, stated, aim all along has been to flatten the curve. We’ve a new infectious disease spreading amongst the population. A disease where the death rate can be ameliorated by good, intensive, health care. Well, we think so at least. So, we have a limit on how much good, intensive, health care we can provide. Thus we want to spread incidences of the disease ridden who require that good, intensive, care over time.

That’s the entire justification for the lockdown. To spread the burden on intensive care units. To save the NHS that is. This is working. And this is described as not being a healthcare policy?

19 thoughts on “Actual, you know, ignorance”

  1. We’ve saved the NHS. Now what?
    We only exist to serve the NHS, the health service only serves us as an accidental by product.

  2. The problem seems to be that channeling all of the NHS resources into dealing with the Covid virus means that more people will be dying of everything else.

  3. The curve looks pretty well flattened, so I’m sure hospitals will soon be admitting cancer patients again.

  4. It really isn’t a consistent policy, is it? The flattening of the curve implies the release of lockdown. Refusing to release lockdown implies that there is no ‘herd immunity’ nor can there be if none of us can catch or pass on the infection. If we come out now, from whom will we catch it? Are we not all now free of risk?

    Even Murphy can legitimately call out inconsistency where it occurs.

    Oh, and the ICUs are possibly responsible for a higher than necessary death rate. Ventilation via intubation kills. The NHS is protecting itself, not its owners.

    Here’s a clip from the EVMS covid protocol which calls out the recommendations of health authorities as mistaken..

    The above pathologies are not novel, although the combined severity in COVID-19 disease is considerable. Our long-standing and more recent experiences show consistently successful treatment if traditional therapeutic principles of early and aggressive intervention is achieved, before the onset of advanced organ failure. It is our collective opinion that the historically high levels of morbidity and mortality from COVID-19 is due to a single factor: the widespread and inappropriate reluctance amongst intensivists to employ anti-inflammatory and anticoagulant treatments, including corticosteroid therapy early in the course of a patient’s hospitalization. It is essential to recognize that it is not the virus that is killing the patient, rather it is the patient’s overactive immune system. The flames of the “cytokine fire” are out of control and need to be extinguished. Providing supportive care (with ventilators that themselves stoke the fire) and waiting for the cytokine fire to burn itself out simply does not work… this approach has FAILED and has led to the death of tens of thousands of patients. The systematic failure of critical care systems to adopt corticosteroid therapy resulted from the published recommendations against corticosteroids use by the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the American Thoracic Society (ATS) amongst others. A very recent publication by the Society of Critical Care Medicine and authored one of the members of the Front Line COVID-19 Critical Care (FLCCC) group (UM), identified the errors made by these organizations in their analyses of corticosteroid studies based on the findings of the SARS and H1N1 pandemics. Their erroneous recommendation to avoid corticosteroids in the treatment of COVID-19 has led to the development of myriad organ failures which have overwhelmed critical care systems across the world. Our treatment protocol targeting these key pathologies has achieved near uniform success, if begun within 6 hours of a COVID19 patient presenting with shortness of breath or needing ≥4L/min of oxygen. If such early initiation of treatment could be systematically achieved, the need for mechanical ventilators and ICU beds will decrease dramatically.

  5. Bloke in North Dorset

    rk,

    That’s very interesting. I was listening to the Dark Horse podcast yesterday and they were saying that the first doctors to start raining this issue on YouTube were taken down because it was against the narrative.

  6. A Twatter thread by our boy Philippe with some rather bitter pills to swallow:

    The cold, hard truth is that you can’t stay locked down until a vaccine is widely available and, once you’re no longer locked down, in most countries (probably all of them in the long-run), there is no realistic strategy that will allow you to keep R below 1.

    https://twitter.com/phl43/status/1259861427621371904

  7. I heard Prof Spiegelhalter on The World At One. He discussed the excess death figures. My summary of what he said (which may well not have been what he meant to say) was, “we’ve protected the NHS, but it hasn’t protected us.”

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    Trying to post a comment re: Actual, You Know, Ignorance

  9. try again:
    In 2018 24 percent of all deaths were at home,, Hospital 22 percent, Hospice 6 percent, Care Home 46 percent. Up to week 16 this year deaths in hospital were 46 percent of all deaths, by week 18 it is down to 44 percent. Care home deaths 23 percent by week 16, 26 percent by week 18. regression to mean.

  10. Despite what has been so frequently said, saving the NHS has never been a relevant goal. The NHS will survive perfectly well regardless. It’s the patients who are at risk of dying (and the medics who catch the disease from them and then become patients too).

    The only sensible aim is to completely crush the disease, driving it to extinction. This policy has been very successful where it has been completently implemented (China, South Korea, Australia, New Zealand). Suppressing the remaining very small outbreaks then becomes quite practical without needing extreme lockdown to continue.

    We don’t want to use lockdown to merely spread a million cases over a manageable timescale. That’s a huge expense to treat them and a large number of deaths while still needing a recessionary level of lockdown which is, of course, also spread over a long time. Once we decide to do anything other than stand back and let people die without treatment it makes sense to take extreme measures over a much smaller timescale.

  11. Charles

    An intelligent time to take the approach you recommend was back in January. At the first sniff of shit out of China. Cut it off and all that (China that is) exactly like you would Ebola.

    The world didn’t. And it’s not as serious as that. Bear in mind that the news has only got better, since the first reports of CFR out of Wuhan.

    Then do the maths.

    Good luck to these countries (NZ etc) if it basically hasn’t ripped and they still intend to stay open for trade.

    The WHO were utterly shite, but not the concept behind it. In this age, it doesn’t hurt if all are singing from the same hymn sheet, whichever hymn sheet that is. If that was Ebola out of Africa, we’d all have got it right. This isn’t, hence – unless there is something we don’t know – let it run through, but mostly among the young, and which will keep the CFR well down.

    Unless there’s a M$ type vaccine……

  12. NZ and Austraia are countries with dispersed housing, easily sealed borders and few initial cases. Good weather helped too. The UK is not in remotely the same position and could not implement elimination.

    The idea that China has CV beaten is ludicrous. Not reported is not the same as not present.

    South Korea thought they did, but they were wrong.

    I might add, NZ is going to be effectively isolated for years yet. There will be substantial costs associated that may yet make our route look unwise. If no vaccine arrives, do we quarantine all visitors forevermore?

  13. Yes, Ritchie is correct and so is that vile Labour MP who argued the same at the PM’s statement yesterday. “Protect the NHS” is this Tory Gov’t’s policy… good! Because the holy and sacred NHS has been Labour’s sole interest for over two decades, it’s one stick to beat the Tories with. Think back to December 2019, its entire election strategy was hoping for a flu epidemic (how ironic) and for photos of very sick children on trolleys in corridors – just think back to those Owen Jones essays. And that is precisely what the Spanish experience served up for them.

    Except this time the Tories have out-flanked them. This time it’s Tory ministers clapping the NHS. This time it’s the Tories shouting “Protect the NHS”. This time the Tories have provided the over-resourced hospitals. And of course, whilst the rest of Europe is clapping carers, we’re clapping THE N..H..S. A friend of mine tried out the “kids on trolleys in corridors” line on me the other day; oh the joy in slapping them down.

    So now, Labour – and Murphy is just a cheerleader after all – are suddenly concerned that there is an over-emphasis on the NHS. Well they’ve realised too late.

    So maybe there hasn’t been the focus on care homes there should have been. Well maybe the unions and Police Federation should have shown more foresight when they lined up their cars and their ambulances outside hospitals, lights flashing, weeping nurses stood outside to thank them. Maybe. And maybe more people are dying quietly in nursing homes because resource went to the NHS. Well we all die someday.

  14. Chester, you and Oz have hard choices to make. We’ve visited NZ a few times for 4-6 week stays. But even with that, 14 days quarantine at the start makes that much less attractive. Also a lot of tours in brochures are only 14 to 17 days so they can’t happen with quarantine.

    We have friends in Oz and we might be too old to contemplate a visit before it becomes practical again

  15. @Charles:

    ” The only sensible aim is to completely crush the disease, driving it to extinction.”

    How did we manage this with Smallpox – the only virus we’ve actually driven to extinction – and how long did it take?

  16. “The problem seems to be that channeling all of the NHS resources into dealing with the Covid virus means that more people will be dying of everything else.”

    The West’s reaction to Covid has been a third world response: shutting down all medicine to focus solely on Covid.

  17. @Jonathan – re smallpox.

    It took a huge effort, decades or time, and lots of money. But that was a much harder task for two reasons: it was the first disease that the methods eradicated, so things were experimental; and the disease was thousands of years old, so very well spread when the attempt was started.

    Unfortunately, with Covid-19 we’re not doing very well compared to where we should be. Many countries foolishly stood back and watched the disease get started in China when they could have been taking action (e.g. screening travellers), so there’s a lot yet to do. But we’re still in a much better place than when smallpox was established all around the world.

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