Covid-19 Discussion

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On that very subject, I've just spent a happy half-hour with Excel and the NHS Statistics COVID 19 total announced deaths 29 October 2020 file, creating some graphs to compare deaths in the initial phase of the pandemic with those that are occurring now, in (what we are told is) the "second wave". I also split the data down to deaths that occurred in those under 60 and those 60 / 60+.

For ease of comparison, I picked the first dates upon which the 7-day moving average of deaths (all ages) first exceeded 10/day (which turned out to be 12th March and 14th September) as the origin for both the initial and current "waves". I haven't split out deaths occurring for those with or without pre-existing conditions. The 7-day moving average is calculated as 4 days back, current, 2 days forward.

Here's the chart for all ages. Note the minor difference ( :rolleyes: ) in the rate of acceleration in deaths between the two "waves":

jz6kOig.jpg


Here's the chart for those 60 and over. Note that the y-axis scale is slightly smaller:

Q91bJZy.jpg


And finally, the chart for those under 60. Note that the y-axis scale is an order of magnitude smaller than that used on the chart for those over 60:

rI80Jyv.jpg

Nice work :thumb:

Would be interesting to see the data for the past 45 days when it becomes available - i.e. the so-called 'second wave'.
 
if you look at the COVID 19 total announced deaths 29 October 2020 – weekly file Excel workbook, the total number of Covid-related deaths in England involving individuals who were under 60 and without a pre-existing condition since the start of the pandemic is 315.

BUT - if you look at the trend, then a rise from zero to 315 deaths of the same cause within one month should get alarm bells ringing

In 8 months, 40 a month.

Is that alarm bell territory? Worth shutting cities and economies down?(Yes you can't put a price on any unnecessary death)
 
Would be interesting to see the data for the past 45 days when it becomes available - i.e. the so-called 'second wave'.
If I've understood you correctly, it's there on the charts already as the orange / dark tan lines, covering the period 14/09 thru 23/10...
 
On that very subject, I've just spent a happy half-hour with Excel and the NHS Statistics COVID 19 total announced deaths 29 October 2020 file, creating some graphs to compare deaths in the initial phase of the pandemic with those that are occurring now, in (what we are told is) the "second wave". I also split the data down to deaths that occurred in those under 60 and those 60 / 60+.

For ease of comparison, I picked the first dates upon which the 7-day moving average of deaths (all ages) first exceeded 10/day (which turned out to be 12th March and 14th September) as the origin for both the initial and current "waves". I haven't split out deaths occurring for those with or without pre-existing conditions. The 7-day moving average is calculated as 4 days back, current, 2 days forward.

Here's the chart for all ages. Note the minor difference ( :rolleyes: ) in the rate of acceleration in deaths between the two "waves":

jz6kOig.jpg


Here's the chart for those 60 and over. Note that the y-axis scale is slightly smaller:

Q91bJZy.jpg


And finally, the chart for those under 60. Note that the y-axis scale is an order of magnitude smaller than that used on the chart for those over 60:

rI80Jyv.jpg
Brilliant Phil - and thank you for taking the time to do it.
 
Healthcare staff in the West Midlands have been told not to start chest compressions or ventilation in patients who are in cardiac arrest if they have suspected or diagnosed covid-19 unless they are in the emergency department and staff are wearing full personal protective equipment (PPE). This policy i would suggest will have contributed significantly to the number of excess deaths during the peak of this health crisis (April/ May.)

 
Healthcare staff in the West Midlands have been told not to start chest compressions or ventilation in patients who are in cardiac arrest if they have suspected or diagnosed covid-19 unless they are in the emergency department and staff are wearing full personal protective equipment (PPE). This policy i would suggest will have contributed significantly to the number of excess deaths during the peak of this health crisis (April/ May.)


Possibly, though this will depend on (a) the actual number of patients in the West Midlands with confirmed or suspected COVID-19 diagnosis who had cardiac arrest while not in the emergency room and while surrounded only by staff not wearing the appropriate PPE, and intuitively I can't really see these particular set of circumstances being a very common occurrence, (b) the percentage of patients in these particular circumstances who not only could have been resuscitated but who also would have made a full recovery and discharged had they not been prevented from receiving CPR or ventilation when they had the cardiac arrest, and (c) whether the medical staff actually adhered to these instructions in all cases.

Without the data, it's obviously impossible to tell what - if any - effect these instructions had on the death toll, but my guess is that there wouldn't have been a huge number of patients dying in these very particular set of circumstances.
 
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Possibly, due this will depend on (a) the actual number of patients in the West Midlands with confirmed or suspected COVID-19 diagnosis who had cardiac arrest while not in the emergency room and while surrounded only by staff not wearing the appropriate PPE, and intuitively I can't really see these particular set of circumstances being a very common occurrence, (b) the percentage of patients in these particular circumstances who ont only could have been resuscitated but who also would have made a full recovery and discharged had they been given CPR or ventilation when they had the cardiac arrest, and (c) whether the medical staff actually adhered to these instructions in all cases.

Withiut the date it's obviously impossible to tell what - if any - effect these instructions had on tbe death toll, but my guess is that wouldn't have been huge numbers of patients dying in these very particular circumstances.
It really depends what advice / instruction is being given to those unfortunate enough to find themselves faced with a person who has stopped breathing. Emergency services would have always advised someone in this situation to perform CPR until paramedics arrive on the scene. Then paramedics would continue CPR on the patient at the scene. If advice during this health crisis is not to perform CPR to avoid the potential spread of viral particles until in a clinical setting then it is absolutely clear those who suffer cardiac arrest will not survive.

This policy also does not appear to be limited to the West Midlands. The World Health Organization lists CPR as an aerosol generating procedure.
 
Interesting article from CEBM on total reported hospital admissions from care homes in England. Broken down by region with number of patients stated.


It is a worry that care homes are also seeing the effect of the second wave - you would have thought that we've learnt how to protect them by now - I was expecting them to be well prepared, and for the elderly to be properly shielded.

After all, these are people living in ideal environment for shielding.

Though it is difficult to tell if the care homes are being hit due to the same administrative blunders as they experienced 7 months ago, or perhaps we simply haven't yet found an effective method for shielding vulnerable people?
 
It is a worry that care homes are also seeing the effect of the second wave - you would have thought that we've learnt how to protect them by now - I was expecting them to be well prepared, and for the elderly to be properly shielded.

After all, these are people living in ideal environment for shielding.

Though it is difficult to tell if the care homes are being hit due to the same administrative blunders as they experienced 7 months ago, or perhaps we simply haven't yet found an effective method for shielding vulnerable people?
In London , the South West and South East the numbers being admiited to hospital from care homes are minimal. In fact the numbers from these areas appear the same as during the summer.
 
It really depends what advice / instruction is being given to those unfortunate enough to find themselves faced with a person who has stopped breathing. Emergency services would have always advised someone in this situation to perform CPR until paramedics arrive on the scene. Then paramedics would continue CPR on the patient at the scene. If advice during this health crisis is not to perform CPR to avoid the potential spread of viral particles until in a clinical setting then it is absolutely clear those who suffer cardiac arrest will not survive.

This policy also does not appear to be limited to the West Midlands. The World Health Organization lists CPR as an aerosol generating procedure.

No disagreement there, the only question is how frequently this actually occurred?

Keeping in mind that:

- The person experienced cardiac arrest

- The person would have had to have a confirmed or suspected diagnosis of COVID-19

- The person would have to be not in an emergency room

- The person would have to be surrounded by medical staff not wearing the appropriate PPE

The more I think about it, the less likely that this actually happened... I just can't see how someone with 'confirmed or suspected diagnosis of COVID-19' ends-up in a medical facility staffed by health workers not wearing PPE? It just doesn't happen. Unless there was some error and a COVID-19 patient was mistakenly wheeled-in to the wrong ward in the hospital etc.

(And, again, even so, sadly many people who receive CPR don't survive, or die later on - any such people would have to be included in the death toll anyway)

Either way, without having any figures to hand, it's all guesswork.
 
In London , the South West and South East the numbers being admiited to hospital from care homes are minimal. In fact the numbers from these areas appear the same as during the summer.

That's good news, so what went wrong in the rest of the country?
 
Interesting (if annoyingly laid out) article from Spain on spread of Covid.


So in summary

- not much risk of transmission from surfaces
- ventillation and masks significantly reduce effect of spread in closed areas
- lots of people talking in a closed environment for several hours builds a huge risk
- classrooms are relatively safe given the numbers because only the teacher tends to do the talking

So this would suggest that public transport is actually pretty safe, schools are manageable (one conclusion would be that teaching is relatively safe while indoor breaks and socialising between teaching sessions are less so), quiet workplaces are safe - particularly if ventillated, bars and clubs and possbly restaurants are risky if people spend time and are loud and engaged and they are not not well ventillated.
 
Waiting for the 5pm news briefing.....

The BBC Health Editor Hugh Pym is saying that COVID-19-related hospital admissions went-up tenfold since August.
 
“This week, the London Ambulance Service revealed that it is now attending an average of 37 suicides a day, or attempted suicides, up from 22 a day in 2019.”

So 50% more suicides in London alone!!!

Very sad, but the obvious question is if more lives are saved overall due to the anti-COVID measures imposed? I don't know the answer to this question.
 
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