Topic: what have we learned from handling epidemics (Read 348 times)

The answer is, don’t wear any PPE at all! This will save time and money and frustration, which will save lives, because the testing done is showing false positives. So there is really no problem beyond what would ordinarily happen for this time of year.

new update (again sorry in advance for concentrating just on UK points)

when it comes to protective equipment for staff treating the sick and elderly
the 'management' teams sourcing the equipment are still implementing a policy that is strange.
ill explain, normal people in towns/cities should keep 2 metres apart.
but nurse/doctor/healthcare treating normal people upclose are not getting the top protective equipment, nor amounts to dispose of/disinfect between patients.
they want only the ICU staff to have the top equipment.

yep if patient has not been tested/diagnosed for covid. you cant use the top PPE.

as for ICU staff that only treat COVID patients that do get the top kit.
this top equipment is not enough to be replaced 6-12 times a day so staff can have a 5 minute break each 1-2hour or get a drink or use the toilet freely during a 12 hour shift. some are only getting a couple

the policy says for staff to take regular breaks due to how clammy and claustrophobic this kit is. yet doesnt realise the amount of times that kit needs to be changed to get those regular breaks.

basically they are restricting staff to only 3~ breaks during 12 hours of work

but because the 'management' pretend 4kit per shit per staff in ICU is enough. they then blame staff for over using kits.
and as for those staff not in ICU wards that are touching patients not yet showing symptoms. not tested. they too are at risk by not even having adequate kit

even more frustrating is this other separate policy
https://www.gov.uk/rest-breaks-work/exceptions

so even though the kit policy notes staff should take regular breaks due to how the kit can overheat the staff.. this second policy of exempting staff from legally being allowed to take a break due to being an 'emergency services or police and they’re dealing with an exceptional catastrophe or disaster' means staff cant even fight for just the permission to go to the toilet without getting told they will be blamed for wasting a kit.
then the hypocritical part
the office working management team who use computers and not facing patients are allowed a 10minute break every hour due to their worry of eye strain.

....
i say this because these no break, work till you faint of dehydration policies should change for the future. as it would also make the supply chains actually order the kit amounts needed. not what amounts a manager can limit it to

newest revelation in the UK
a stupid politician has been saying health workers are using more PPE than they need.
so let me explain
politician said for doctors to be careful about hand washing to put on their PPE. make sure is safe secure and comfortable and then not touch it again unless its to take it off.

they then set a maximum allowance of a few sets per 12 hour shift.
but here is the problem.
if a doctor/nurse wanted a glass of water. they would have to take the kit off.have a drink. new kit on
a bathroom break. kit off, use bathroom, new kit on.
lunch break kit off. eat. new kit on
jsut need a 5 minute breather to cool down from the confined sweaty exhaustiion.. kit off. 5 minutes. new kit on

also other doctors from other departments are being called in to help with the surge of cases. so more PPE gets used per hospital due to more people on the specialist ward.

so here is the foolish thing
doctors are not robots that only need to have a single 30minute cool down every 12 hours. they need to eat and drink and go toilet multiple times.
but the politician is just providing minimum kit and trying to get doctors and nurses to jut push on through, and only drink and bathroom break during a single lunch break
and stay on ward the rest of the time to not spread it outside the ward.

a few weeks ago some hospitals were only given one set that meant to last the whole day.

hospitals shouldnt have to ration protective gear nor get told by politicians to risk their health of exhaustion/dehydration just to keep supplies at a low use.

doctors should be allowed to take off their kit and take a 5 minute breather offward if they are getting overheated after a few hours. being told to keep going for maybe 6 hours is bad. blaming them for wanting to take a break is bad

politicians should have been approaching PPE manufacturers back in january/february to ramp up production. not march/april
and not trying to finger point at the doctors and nurses as the party to blame

.. facepalm to this
https://www.independent.co.uk/news/health/coronavirus-nhs-hospital-masks-ban-symptoms-uk-latest-a9355761.html
"Hospitals have been warned that local stockpiling is unnecessary and, from Thursday last week, hospitals were only able to order their normal amount of masks.

NHS Supply Chain, the body that handles equipment stocks for NHS hospitals, said it is now imposing controls to “maintain continuity of supply across the network.”

We all saw that medicine of such countries as Italy, Spain, USA and almost all other countries were simply not ready for coronavirus. Instead of developing medicine, the governments of all countries are spending huge amounts of money on wars. The WHO has really upset me. Coronaviruses have been known for a long time and I see no point in having such an organization if it is unable to take measures to prevent such epidemics.

a lesson yet to be learned in america
while those on minimum wage ($7.50/h=$15.6k/y) get a one time only $1k boost to their income.. which is ~6%

the inflation rate due to the trillions of spending on al projects will amount to more then 6%
poorer will be even poorer next year

retailers will have to make more profit to make up this financial quarters loss, and future financial quarters in the next waves.. so expect prices to increase alot. but only in small increments to not raise alarm

its like throwing the frog into boiling water will shock it and will jump out with burns. but putting a frog in saucepan of water and turning heat on slowly, boils the frog without realising it

the worst you can do is listening to the left, who constantly wants to prints thrillions and brillions until there is nothing left of the government

Have learnt to say with my family in time of crisis and when there is no crisis because only them can stay by you in time of you downfall or problems

ok i spoke bout the political before.. now for the society

GOOD: technology and delivery makes it easier now than say 1950's (no rationbook)
GOOD: people realise how consumer lifestyle they were, realising how much they can survive without luxury
GOOD: we have the microscopes and biology research to learn about things fast
GOOD: we have the tech to communicate things fast

BAD: we have the technology for fraudsters hoaxers, scammers, conspiracies to communicate fast
BAD: hospitals underfunded (worth mentioning everytime as its the biggest impactor)
BAD: modern kids/idiots thinking they are lawless immortals who cant be told what to do


....
we dont have enough beds if even 1% of the population had severe symptoms. so
superbad: multiple waves of lockdown > release > lockdown > release in 2-4 month gaps
superbad: more deaths even after this first lockdown

GOOD : we are concern with hand wash now, always try to be clean
GOOD : pollution in many places has reduced
GOOD : we use shopping online
GOOD : we apply physical distancing in the public area
GOOD : people become care with their family
GOOD : the relationship between the family member become closer
GOOD : if people don't have an urgent thing, they will stay at home
GOOD : parents always try to tell their kids about being healthy now
GOOD : parents concern about their kids
GOOD : people can work from home
GOOD : people use technology to talk with other people using video call
GOOD : people try to consume healthy food
GOOD : people always want to prevent from sick by eating vitamins, supplements, healthy food and go to the doctor now if their body is not feeling healthy

BAD : people become suspicious with new people who come to their home
BAD : too much worry about the bad news from social media like WhatsApp, Facebook, Line
BAD : some of them busy with their gadget to search about the update news
BAD : people talk less with each other
BAD : social contact has been reducing
BAD : people smarter than the medical officers because they can get information from social media
BAD : visiting other people house's is not necessary now
BAD : too careful with anything that might happen to them
BAD : the criminals can increase because people having difficulty to find new jobs
BAD : the hospital cannot accept all people who want to check their health
BAD : some people still try to go out even their government already give a warning
BAD : some people try to create hoax news in the social media which can make panic in the society
BAD : procedures to get the right information about the people's health is too long in some hospitals

there will be a second wave.


UK only had 4k ICU beds in march. yep london in april opened nightingale with 500beds but ability to quickly go upto4k (8k total)

but running the math
65million people and not even 1% have been tested/symptomatic/immunised by recovery

this week with other small adjustments. allowed for ~6k occupancy this week.
imagine if the other 99% got it and where the small percent who got severe symptoms .. the numbers are way way way way above the 6-8k

just think about it
64m
May 1st  2.6 severe symptomatic
May 7th 6.76 severe symptomatic
....
July 24th ~5k  and lockdown needed before that(1st-2nd week of july). because without it august 1st would have over 12k needing a bed

if there was no second lockdown.. by september 15th all uk population would have it.. but would have 1mill needing beds
obviously without beds. lots will die


current death numbers are low on media stats.. but these stats include isolation delay. and also hopes to keep the infection curbed in waves below hospitial capacity.. where lockdowns roll multiple times for upto 2 years

but with no second lockdown. the death and severity gets worse.. and gets worse fast
EG. if lockdown released May 1st. and no lockdown in july
by mid september everyone would have contracted it. but 1m would be needing hospital beds
we just dont have that. so no way will they let it just go wild 'herd immunity' no second wave

..
so waves of rolling lockdowns seems the sensible way
as for what to do in the interim between waves.
starting business for ~2month. then locking down. can cause alot of trouble
especially for all those businesses that did not furlow their staff but sacked them.
trying to hire new staff train them just to shut down after 2 months is not good.

same with those businesses that went into administration. trying to get out of it/start from fresh.. for 2 months. wont help

however the idea was to furlow staff, and offer businesses grants to prod them along.. to allow more fluid to go back to work for 2 months. then another 2 month 'work holiday'. on a rolling bases

in hnidsight though. governments should have planned this in january-february. . heck even in march when they finally released the 'benefits' budget. they should not have said they wont pay out for 2-3months. thats just too late

to get to a point of not needing any lockdown the NHS would need 100k-500k beds
but that is not going to happen before june-july

It's obvious that we aren't going to live as we used to live before pandemy anytime soon. In most countries peak wasn't reached and number of new cases is still huge and it's dropping insignificantly. So, yeah, it's too early to talk about getting back to normal life. And even when number of new cases will become minimal and controlled, removing all quarantine restrictions would be stupid. Everything should be done step by step. Opening shops, restaurants, parks, public transport, factories and all other public places should be made, because current situation is disaster for economy. But only when it will be safe to do it. And there should be all precautions - distance between people, masks, minimal number of people allowed to enter at once and etc.
Yeah, there is predictions that 80%-90% of population are yet to get virus. Because it will not simply disappear without people's immunity from it or vaccine. And new, much bigger wave may happen in autumn. As you said, it's very important to prepare well for it. I think it will be most important to protect people who are most vulnerable - elderly people, people with serious health problems and etc.

yes the % of doctors getting it and in a viral load so massive that soem are dying quick does reveal the lack of resources.
and it brings up my very questions of, why did UK/US learn about it on january9th but still went on with business as usual until 2 months later in march..

also. thinking the numbers are huge now.. thats with 95% of general population YET TO GET IT
so if a lockdown sopped today expect a 20x fold of problems in next coming months..

when it come to trying to get back to business as usual.
there are a few plans

1. once the first wave has peaked, relax the lockdown and have 2 months of a break where everyone is alllowed to do anything again... and then enter another lockdown in the second wave but with more allowance with hopefully by then a 3x ICU bed capacity.
this is not good because trying to get people back to work and restart factories and retail. just to tell them to shut it down again in 2 months wont be good.

2. let the first wave curve back down to such an extent that those remaining low instances of infections can be fully monitored of who they came into contact with and fully restrict those contacts. hoping to not let it spread.
this is not good, although it worked for places like wuhan in the first wave.. it does noting for the majority yet to get it who might contract it via importing/exporting it when they travel to different places.
end result is that it might mean the second wave can be controlled and not need a full lockdown as quickly as plan A

3. only let the recovered return to work and gently let only a certain retail type restart. in stages rather then just let everyone out in one go.
again its still stalling. but can start to see the economy start more smoothly, one industry sector at a time

all in all we are to see not weeks but months/years of events ahead.
lets just hope the second wave is more controlled and planned and prepared than the first one.

Well, you have nailed main aspects. Even most powerful countries - China, USA, whole EU, UK, wasn't ready for this pandemy. Not even talk about poor developping countries. Not many accepted this virus seriously. It was difficult to expect such thing and that virus will spread so fast globally. Most countries reacted too late. These which reacted way too late, now have worst outcomes.
One point that I want to add - very big % of infected people are doctors. So, it's obvious that they didn't had enough protection. And worst part that they infected other people who were in hospital. So, in many places hospitals were place were virus spread...
And now I'm wondering for how long governments are going to keep quarantine. Because virus will not simply disappear one day. It's impossible to test all people and it's very likely that virus will continue to spread for very long time. Especially because some people have it without any symptoms. Offcourse, lifes of people is important, but governments can't afford keeping quarantine for half year let's say, because whole economy will be killed.
It's interesting how Sweden handling this situation. They have made some restrictions, but there is no complete quarantine in the country, and people still living pretty much normal life. I read that Norway are planning to open schools and universities after easter too.

We should have learnt that Mother Nature ( God ) is the ultimate authority, and she has massive power to restore equilibrium. The Virus is getting all the publicity at the moment, but the plagues of locusts and vermin are also of great significance. The sun's power to change climate shouldn't be ignored either.

Probably the biggest thing that we have learned is that our leaders - our governments - don't know much if any more than we do... but that they can botch the whole thing up a lot easier than we can.

protocol id like to see for the next pandemic
contact tracing:- finding people who came into contact with known sufferer, and fully self isolate them.

no repatriation:- if a country/city is overwhelmed (more then just a handful of cases) then control the borders.
                         its cheaper to just pay the vacationer to stay there, rather than try getting the vacationer back,
                         with all the risks of passing it to new countries. stay in vacation country or come back and 14day isolate

hospitalfunding:- make healthcare the number 1 funded service, above military, above foreign aid, above corp taxbreaks

facility prepare:- dedicate a certain hospital wing/clinic thats separate from the rest to handle epidemic.
                         thus not interupting/mixing with other critical non epidemic patients

The biggest thing is that we were neglecting having the proper infrastructure setup for an event like this. Everyone in power thought -- well it probably won't happen again (after Ebola) and they disregarded that this was a nagging risk. Public health experts on the otherhand have been talking about how government and private industry should be devoting resources to proper research.

We knew this was a problem after Ebola happened. We got lucky because Ebola wasn't as infectious and we were able to control the few people that we knew had it.

As Bill Gates said, we need to begin fighting pandemics like we fight wars. Prepare for it in advance and be more then ready next time. All the money that the US spent on the military this year -- 800B or so -- couldn't help much in the fight against the coronavirus.

Watch this video - https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re_not_ready?language=en

Almost every country relied too much on WHO announcement but WHO fucked up too. Countries waited until COVID-19 was declared a pandemic before they acted causing their citizens to panic. They could have prevented travelers coming in from China as early as January but that would have created another issue which could affect their economy since most of them trades with China.

So this pandemic event has shown the world some surprising things.
such as how different countries handle a pandemic.

so to get our thinking caps on and think about best practices for the future. lets list the good and the bad things that can change the velocity of tragedy.

ill list a few
BAD: hospital lack of capacity and resources - all countries
BAD: no chasing of close contacts where it might have passed on - most countries
BAD: waiting months before implementing ordering resources, requesting people to change habits -all countries
BAD: continuing to allow cross border transport/repatriation between different areas -all countries


i predict people will moan about the 'isolation'.. yes we know it has changed our lifestyle habits/routines. and that is always going to be the case in a pandemic. but instead of complaining about it generally. mention the good and bad about the specifics of it

so folks list some good and bad things you have noticed about this event and what can be used, avoided for a better policy in the future thats best for peoples health and survival (not based on convenience)

*self moderated purely to weed out the conspiracy trolls/ pandemic deniers
anything else is permitted