SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

Anyone know more information about these CPAP (Continuous positive airway pressure) machines that Mercedes are apparently producing? How quickly are these likely to be distributed en masse?

https://www.bbc.co.uk/news/health-52087002

Apologies if this discussion has already taken place.

Dr. John Campbell is very optimistic that this could massively reduce the pressure on the healthcare system, as well as the bodies of those hospitalised, and eventually ventilated/intubated.

 
Grinner said:
Reading now. Out of interest, are doctors able to tell that hypertension exists when a patient is admitted, or is it all down to what's in their medical record?
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It's a chronic condition so it can only be diagnozed over a relatively long period of time. So it's done with the medical record, when you are admitted they will simply note that you have an elevated blood pressure and monitor it.
 
We had an interesting press conference today. The doctors read out the numbers of dead and newly discovered, added that this is a consequence of a lack of discipline and stormed out.

A 24/7 curfew is incoming...
 
JPRouve said:
It's a chronic condition so it can only be diagnozed over a relatively long period of time. So it's done with the medical record, when you are admitted they will simply note that you have an elevated blood pressure and monitor it.
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I doubt anyone admitted to hospital wouldn’t have an elevated BP. I’d be bloody petrified!
 
Ole90+3 said:
Anyone know more information about these CPAP (Continuous positive airway pressure) machines that Mercedes are apparently producing? How quickly are these likely to be distributed en masse?

https://www.bbc.co.uk/news/health-52087002

Apologies if this discussion has already taken place.

Dr. John Campbell is very optimistic that this could massively reduce the pressure on the healthcare system, as well as the bodies of those hospitalised, and eventually ventilated/intubated.

Click to expand...


So I have a colleague working in Northern Italy who has said their ward is all patients on CPAP machines. It does seem to work quite well.

The issue though is that CPAP is an aerosol generating procedure (AGP), which means it basically sprays aerosols (containing the virus) all over the place. Most London trusts have actually stopped using NIV (of which CPAP is a part) due to the risk of this.

AGPs by themselves can still happen (and we are still having to do them anyway). Problem is that the current PPE guidance in the UK is a bit of a shambles anyway (surgical mask, apron and gloves for Covid confirmed patients), partly because we don't have enough of the full kit. Being around a patient while they're having an AGP means you need the full PPE ie:


nejmvcm1412105_f1.jpeg


We don't currently have enough of this to be doing AGPs regularly on normal wards.

That is as much of a barrier as availability of the CPAP machines.
 
africanspur said:
So I have a colleague working in Northern Italy who has said their ward is all patients on CPAP machines. It does seem to work quite well.

The issue though is that CPAP is an aerosol generating procedure (AGP), which means it basically sprays aerosols (containing the virus) all over the place. Most London trusts have actually stopped using NIV (of which CPAP is a part) due to the risk of this.

AGPs by themselves can still happen (and we are still having to do them anyway). Problem is that the current PPE guidance in the UK is a bit of a shambles anyway (surgical mask, apron and gloves for Covid confirmed patients), partly because we don't have enough of the full kit. Being around a patient while they're having an AGP means you need the full PPE ie:


nejmvcm1412105_f1.jpeg


We don't currently have enough of this to be doing AGPs regularly on normal wards.

That is as much of a barrier as availability of the CPAP machines.
Click to expand...

Have you seen the presentation doing the rounds about the PPE protocol for the Chinese HCWs transferred to Wuhan? They had incredibly thorough protection. Including people who spent all day doing nothing but checking and helping don/doff PPE for their colleagues. End result, 42000 additional workers with 0% infections. Unbelievable really.

Also, yeah, everyone seems to be shit scared of NIV. The initial advice from China was avoid at alll costs but that stance does seem to be changing. Still a very risky tactic in hospitals like ours, where PPE is limited, at best.
 
worldgonemad said:
Are lots of people still flouting the regulations then @11101 ? I thought that by now the whole of Italy is very tightly locked down
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It's relative. The streets are extremely quiet but you do notice the same few people walking up and down multiple times per day with the same shopping bag in their hand.
 
Ole90+3 said:
Anyone know more information about these CPAP (Continuous positive airway pressure) machines that Mercedes are apparently producing? How quickly are these likely to be distributed en masse?

https://www.bbc.co.uk/news/health-52087002

Apologies if this discussion has already taken place.

Dr. John Campbell is very optimistic that this could massively reduce the pressure on the healthcare system, as well as the bodies of those hospitalised, and eventually ventilated/intubated.

Click to expand...

@Ole90+3 My missus uses a cpap machine as she has sleep apnea . They work by forcing air into the airway via a mask which fits over the mouth and nose . A motor pulls air from the room and forces it into the mask , Imagine a hairdryer , air being sucked in and funnelled through a hose into the mask . The one she uses senses how much air she is needing to keep her airway open and adjusts flow accordingly . I suspect the ones being developed must also add oxygen into the mask as from what i understand , covid patients need a substantial amount of extra oxygen .
 
worldgonemad said:
just been on the bbc that 393 people have sadly died in the uk in the last 24 hrs . Very sad news and a significant rise from yesterday . Hopefully this is not the start of a steep increase in numbers . The report didnt say what the new confirmed cases were .
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It's going to go a lot higher than this.
 
africanspur said:
So I have a colleague working in Northern Italy who has said their ward is all patients on CPAP machines. It does seem to work quite well.

The issue though is that CPAP is an aerosol generating procedure (AGP), which means it basically sprays aerosols (containing the virus) all over the place. Most London trusts have actually stopped using NIV (of which CPAP is a part) due to the risk of this.

AGPs by themselves can still happen (and we are still having to do them anyway). Problem is that the current PPE guidance in the UK is a bit of a shambles anyway (surgical mask, apron and gloves for Covid confirmed patients), partly because we don't have enough of the full kit. Being around a patient while they're having an AGP means you need the full PPE ie:


nejmvcm1412105_f1.jpeg


We don't currently have enough of this to be doing AGPs regularly on normal wards.

That is as much of a barrier as availability of the CPAP machines.
Click to expand...

Does the bubble helmet thing they are using in Italy help with that?
 
Things are happening here in small Norway now, My local regional hospital has developed its own corona test so they are no longer in need of imported products for testing. A new emergency ventilator (combination of old hand ventilator and mechanical pumping) has been designed by a defence research company and a private company and will start production mid April. Government has ordered 1000 units but says production capacity will be increased and we will not need them all here, so we will help other nations also. Many private companies, 3d-printing groups and high schools are using new designs and 3d printing to make face masks for health personnel. Private persons in what we call "sewing unions", often old ladies, also schools that are doing sewing etc, are producing PPE dresses. Liquor factories have produced liquid disenfectants etc. Norway is mobilizing through the people in what we call "Dugnad", norwegian old tradition for local cooperation to help eachother. Great to see that this nation has not forgotten what it once was. People are coming together and uniting more and more. Great to see. We might not be large or have much production at home of everything but things can get done when there is will and togetherness.
 
Last edited:
19 year old with no underlining health problem dies in the U.K.
12 year old with no underlining health problem dies in Belgium.
I’m starting to think this depends on how bad you get it and it can kill anyone
 
africanspur said:
So I have a colleague working in Northern Italy who has said their ward is all patients on CPAP machines. It does seem to work quite well.

The issue though is that CPAP is an aerosol generating procedure (AGP), which means it basically sprays aerosols (containing the virus) all over the place. Most London trusts have actually stopped using NIV (of which CPAP is a part) due to the risk of this.

AGPs by themselves can still happen (and we are still having to do them anyway). Problem is that the current PPE guidance in the UK is a bit of a shambles anyway (surgical mask, apron and gloves for Covid confirmed patients), partly because we don't have enough of the full kit. Being around a patient while they're having an AGP means you need the full PPE ie:


nejmvcm1412105_f1.jpeg


We don't currently have enough of this to be doing AGPs regularly on normal wards.

That is as much of a barrier as availability of the CPAP machines.
Click to expand...
Imagine how hot and uncomfortable that is? And are they wearing it for 10-12 hour shifts?
 
TheReligion said:
Can't say I agree with this. With regards to a lockdown it's evident around the world that people need to adhere to it. I'm not sure how much more obvious that needs to be?
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It doesn't really matter how obvious it is. It's not really in law and if it was there'd be rioting. People are adhering to it based entirely on their trust in the system and the people in charge of managing what to do...and here the level of trust would already have been very low, and on top of that the people in charge who are meant to know what's going on, keep changing their fecking minds.

On top of that, half of what we are getting told just isn't true. Apparently I only have to go out to exercise and get my own shopping, but actually I've been out more than I usually would because it turns out I also have to get both my parents shopping seperately because they are both on the at risk list and are getting zero help from the government...and I can't even get things in one go because of all the item limits in supermarkets. So I'm being told to stay in at all costs but also forced to be out and among other people 3x as much as should be necessary.

At a certain point people, particularly when in a stressful situation, start to wonder if the system is helping or hindering them.

I don't think a lot of other countries have this level of distrust or dissorganisation. I've spoken to friends in Sweden and Germany. The restrictions are similar but they have both said their governments have been very clear and consistent the whole time and just given them the facts, and people are generally getting help where needed.

Unfortunately I think the route of the problem is that the people running things in this country just aren't particularly smart.
 
Just caught the end of a segment on LBC that said the government hasn't done any modeling as to at what point the measures against coronavirus would cause a greater loss of life than coronavirus itself.

It said that modelling suggests the 2008 recession cost more days of life than coronavirus would have with no government counter measures whatsoever.

I'd like to see the statistics because intuitively to me it feels like if the measures are maintained for a few more weeks the economic effect on life will be worse than the virus would've been.
 
Pogue Mahone said:
Have you seen the presentation doing the rounds about the PPE protocol for the Chinese HCWs transferred to Wuhan? They had incredibly thorough protection. Including people who spent all day doing nothing but checking and helping don/doff PPE for their colleagues. End result, 42000 additional workers with 0% infections. Unbelievable really.

Also, yeah, everyone seems to be shit scared of NIV. The initial advice from China was avoid at alll costs but that stance does seem to be changing. Still a very risky tactic in hospitals like ours, where PPE is limited, at best.
Click to expand...

Yep, they've perhaps gone slightly overboard with it but its worked. I don't know why we're struggling so much to pick up appropriate PPE but it isn't helping staff morale. 3 doctors have died already in the UK, I believe a nurse has as well.

And for sure. I certainly wouldn't see a patient on the ward on NIV without proper PPE right now.


11101 said:
Does the bubble helmet thing they are using in Italy help with that?
Click to expand...

It does help but I still wouldn't be 100% comfortable that they're stopping the aerosols and wouldn't see a patient without the proper PPE, even if they had that hood on.
 
Pogue Mahone said:
Have you seen the presentation doing the rounds about the PPE protocol for the Chinese HCWs transferred to Wuhan? They had incredibly thorough protection. Including people who spent all day doing nothing but checking and helping don/doff PPE for their colleagues. End result, 42000 additional workers with 0% infections. Unbelievable really.

Also, yeah, everyone seems to be shit scared of NIV. The initial advice from China was avoid at alll costs but that stance does seem to be changing. Still a very risky tactic in hospitals like ours, where PPE is limited, at best.
Click to expand...

That is absolutely unbelievable!!
 
432JuanMata said:
19 year old with no underlining health problem dies in the U.K.
12 year old with no underlining health problem dies in Belgium.
I’m starting to think this depends on how bad you get it and it can kill anyone
Click to expand...

Happens with any serious illness even flu there is always an unlucky number that succumb just isn't pushed in your face on the news everyday.

Still incredibly sad, but its incredibly rare.
 
432JuanMata said:
19 year old with no underlining health problem dies in the U.K.
12 year old with no underlining health problem dies in Belgium.
I’m starting to think this depends on how bad you get it and it can kill anyone
Click to expand...

Any virus if you're very unluckly or catch it at the wrong time can kill an otherwise healthy person. The flu kills thousands of otherwise relatively healthy people per year.

It's also not clear what "no underlying health conditions" really means. It doesn't necessarily mean the person is fit and healthy.

Generally the sevidence suggests the overall mortality rate for this is probably less than 1%, which suggests it's only a significant risk to someone who is already in a vulnerable state...but that does add up to a lot of people and you will also get the odd one off instance. This is why hospitals already struggle in the winter when other viruses such as influenza are more prominent.

Plus, the last time they said a young person with no underlying health conditions died of it here, it turned out they died of a heart attack. I'm not a medical professional but I'm fairly certain you can't die of a heart attack without there being an underlying health condition, and I'm even more certain you can't die of a heart attack directly because of corona virus.
 
Shane88 said:
Imagine how hot and uncomfortable that is? And are they wearing it for 10-12 hour shifts?
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Yeah, its truly stifling. In China, they were wearing it for a maximum of 6 hours.

In our hospital, we're saying optimally 2 hours before you come out of it and a maximum of 4.

Genuinely even just a surgical or respirator mask is quite stifling when you've been wearing it for even 20-30 minutes.
 
432JuanMata said:
19 year old with no underlining health problem dies in the U.K.
12 year old with no underlining health problem dies in Belgium.
I’m starting to think this depends on how bad you get it and it can kill anyone
Click to expand...

When they say no underlying health problems, I assume they mean no known underlying health problems? Which is possibly a different thing, especially if it's a health problem that would have been diagnosed as they got older.

Not that it makes it any less grim. :(
 
finneh said:
Just caught the end of a segment on LBC that said the government hasn't done any modeling as to at what point the measures against coronavirus would cause a greater loss of life than coronavirus itself.

It said that modelling suggests the 2008 recession cost more days of life than coronavirus would have with no government counter measures whatsoever.

I'd like to see the statistics because intuitively to me it feels like if the measures are maintained for a few more weeks the economic effect on life will be worse than the virus would've been.
Click to expand...
I predicted from the start that the current measures would lead to greater long-term problems and losses of life. The current trajectory could lead to big social unrest and even regional conflicts around the world - the fight for resources would become bigger than ever.

I'm seriously disappointed in the lack of drastic cooperation to deal with this unforeseen crisis. To me it seems like a lot of the big countries are trying to isolate themselves and protect their own first, when this will have devastating effects on the whole world. But I guess the rich are expecting to still survive after the big hit, leaving the poor nations to fend for themselves. It's staggering that the EU or even NATO have had no actual plan in dealing with such severe and sudden circumstances. It makes me wonder what would the reaction be if actual serious conflicts were to happen in closer proximity to the major players in those alliances.
 
Grinner said:
Reading now. Out of interest, are doctors able to tell that hypertension exists when a patient is admitted, or is it all down to what's in their medical record?
Click to expand...

Still a bit puzzling to me the hypertension one. Some governments, including the UK don't even list it as a risk factor as far as I can remember and other do. I am a bit suspicious that it's potentially blood pressure medication causing something here. Pure speculation though.
 
noodlehair said:
Any virus if you're very unluckly or catch it at the wrong time can kill an otherwise healthy person. The flu kills thousands of otherwise relatively healthy people per year.

It's also not clear what "no underlying health conditions" really means. It doesn't necessarily mean the person is fit and healthy.

Generally the sevidence suggests the overall mortality rate for this is probably less than 1%, which suggests it's only a significant risk to someone who is already in a vulnerable state...but that does add up to a lot of people and you will also get the odd one off instance. This is why hospitals already struggle in the winter when other viruses such as influenza are more prominent.

Plus, the last time they said a young person with no underlying health conditions died of it here, it turned out they died of a heart attack. I'm not a medical professional but I'm fairly certain you can't die of a heart attack without there being an underlying health condition, and I'm even more certain you can't die of a heart attack directly because of corona virus.
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This is true..to an extent. Some of the people I'm seeing written about 'no comorbidities' have actually been obese for example. Now, that isn't a comorbidity per se but certainly isn't healthy for you either and your organs will already be under more strain than it should be.

Some people actually are getting what's called myocarditis from Covid-19 and some studies suggest its the cause of death in 7% and a contributing factor in up to 1/3 of patients. You don't necessarily need to have a medical issue to get myocarditis but it obviously increases your chances of surviving it if you are otherwise healthy.

While Covid itself is horrible, I'm actually still more concerned by its effects on the general HC system. For multiple reasons. It fills up ITUs. That means other patients who should go to ITU aren't anymore. I had a quick peek at our (humungous) ITU yesterday. There were 2 non Covid ARDS patients out of 35. They're keeping beds open pretty much only for Covid.

We've cancelled all but emergency surgeries.

People are scared to come to hospital now. Which means we're seeing things that are quite unusual in this day (for example, heart wall rupture, which we so rarely see now in the PCI era for heart attacks). I am convinced that patients are dying at home because these emergency presentations haven't suddenly disappeared into thin air. Our admissions for STEMIs (the most severe heart attacks) and strokes have both gone down. We've stopped accepting neurosurgery patients. Which means patients we may be operating on and saving lives....we're now not.

And we're still not at the peak yet.
 
noodlehair said:
Any virus if you're very unluckly or catch it at the wrong time can kill an otherwise healthy person. The flu kills thousands of otherwise relatively healthy people per year.

It's also not clear what "no underlying health conditions" really means. It doesn't necessarily mean the person is fit and healthy.

Generally the sevidence suggests the overall mortality rate for this is probably less than 1%, which suggests it's only a significant risk to someone who is already in a vulnerable state...but that does add up to a lot of people and you will also get the odd one off instance. This is why hospitals already struggle in the winter when other viruses such as influenza are more prominent.

Plus, the last time they said a young person with no underlying health conditions died of it here, it turned out they died of a heart attack. I'm not a medical professional but I'm fairly certain you can't die of a heart attack without there being an underlying health condition, and I'm even more certain you can't die of a heart attack directly because of corona virus.
Click to expand...
It might be better to say 'no known underlying health conditions'.
 
finneh said:
Just caught the end of a segment on LBC that said the government hasn't done any modeling as to at what point the measures against coronavirus would cause a greater loss of life than coronavirus itself.

It said that modelling suggests the 2008 recession cost more days of life than coronavirus would have with no government counter measures whatsoever.

I'd like to see the statistics because intuitively to me it feels like if the measures are maintained for a few more weeks the economic effect on life will be worse than the virus would've been.
Click to expand...
I made that argument weeks ago to argue that a lockdown had to be held back as long as possible, but it is not a popular one. I've never been in doubt that the knock-on effects of the coronavirus situation will cost far more healthy life years than the virus itself.
 
noodlehair said:
It doesn't really matter how obvious it is. It's not really in law and if it was there'd be rioting. People are adhering to it based entirely on their trust in the system and the people in charge of managing what to do...and here the level of trust would already have been very low, and on top of that the people in charge who are meant to know what's going on, keep changing their fecking minds.

On top of that, half of what we are getting told just isn't true. Apparently I only have to go out to exercise and get my own shopping, but actually I've been out more than I usually would because it turns out I also have to get both my parents shopping seperately because they are both on the at risk list and are getting zero help from the government...and I can't even get things in one go because of all the item limits in supermarkets. So I'm being told to stay in at all costs but also forced to be out and among other people 3x as much as should be necessary.

At a certain point people, particularly when in a stressful situation, start to wonder if the system is helping or hindering them.

I don't think a lot of other countries have this level of distrust or dissorganisation. I've spoken to friends in Sweden and Germany. The restrictions are similar but they have both said their governments have been very clear and consistent the whole time and just given them the facts, and people are generally getting help where needed.

Unfortunately I think the route of the problem is that the people running things in this country just aren't particularly smart.
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It is in law though. That's the point to a degree. Everyone was asked initially yet seemed to want to find ways to get around it so legislation has now been passed. Also if you are a carer you do have a travel exemption so that covers your additional movement.

At the end of the day we police by consent however some people will continue to be selfish and continue to disobey instructions. Those people need enforcement as there's simply no other way.
 
Supermarkets lifting restrictions on item limits. Great. I already struggle to buy chicken as it is.
 
TMDaines said:
I made that argument weeks ago to argue that a lockdown had to be held back as long as possible, but it is not a popular one. I've never been in doubt that the knock-on effects of the coronavirus situation will cost far more healthy life years than the virus itself.
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Yep I've been saying this since the start (or at least saying it should be an important consideration) but it actually seems to make people quite angry.

You also have to account for the fact there are millions in this country already living in poverty and with high levels of stress on their mental and physical wellbeing...and a lot of those have now had their income taken away.

I think realistically you're only looking at about 2 weeks before it's a very big problem.
 
finneh said:
Just caught the end of a segment on LBC that said the government hasn't done any modeling as to at what point the measures against coronavirus would cause a greater loss of life than coronavirus itself.

It said that modelling suggests the 2008 recession cost more days of life than coronavirus would have with no government counter measures whatsoever.

I'd like to see the statistics because intuitively to me it feels like if the measures are maintained for a few more weeks the economic effect on life will be worse than the virus would've been.
Click to expand...

It would be quite hard to do that sort of modelling given a) the extent of the economic crisis is dependent on what other countries do too and b) the impact of the economic crisis is dependent on the economic response, which is also heavily dictated by other countries and future policy decisions. It's not for nothing that some argue that austerity cost lives rather than the crash itself. And as a side note, the UK would presumably also have less influence on the response of their neighbouring countries post-Brexit than they would have pre-Brexit.

In that context I'm not sure how much agency the UK would gain by prioritising the economy more, independent of what other countries were doing. They'd still be awash in a global crisis, having presumably just been hit harder than other countries in terms of direct coronavirus deaths. Tough call to make at a point when the economic consequences are more difficult to predict that the immediate health consequences.
 
Bosws87 said:
Happens with any serious illness even flu there is always an unlucky number that succumb just isn't pushed in your face on the news everyday.

Still incredibly sad, but its incredibly rare.
Click to expand...
noodlehair said:
Any virus if you're very unluckly or catch it at the wrong time can kill an otherwise healthy person. The flu kills thousands of otherwise relatively healthy people per year.

It's also not clear what "no underlying health conditions" really means. It doesn't necessarily mean the person is fit and healthy.

Generally the sevidence suggests the overall mortality rate for this is probably less than 1%, which suggests it's only a significant risk to someone who is already in a vulnerable state...but that does add up to a lot of people and you will also get the odd one off instance. This is why hospitals already struggle in the winter when other viruses such as influenza are more prominent.

Plus, the last time they said a young person with no underlying health conditions died of it here, it turned out they died of a heart attack. I'm not a medical professional but I'm fairly certain you can't die of a heart attack without there being an underlying health condition, and I'm even more certain you can't die of a heart attack directly because of corona virus.
Click to expand...
sullydnl said:
When they say no underlying health problems, I assume they mean no known underlying health problems? Which is possibly a different thing, especially if it's a health problem that would have been diagnosed as they got older.

Not that it makes it any less grim. :(
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Thanks for the replies I guess it can catch anyone off guard, it is very low(near non existent) at a young age but it’s so sad to see
 
TMDaines said:
I made that argument weeks ago to argue that a lockdown had to be held back as long as possible, but it is not a popular one. I've never been in doubt that the knock-on effects of the coronavirus situation will cost far more healthy life years than the virus itself.
Click to expand...

What knock on effects are you thinking of? Economic / mental health & wellbeing?
 
africanspur said:
Yep, they've perhaps gone slightly overboard with it but its worked. I don't know why we're struggling so much to pick up appropriate PPE but it isn't helping staff morale. 3 doctors have died already in the UK, I believe a nurse has as well.

And for sure. I certainly wouldn't see a patient on the ward on NIV without proper PPE right now.




It does help but I still wouldn't be 100% comfortable that they're stopping the aerosols and wouldn't see a patient without the proper PPE, even if they had that hood on.
Click to expand...

At least you might soon be wearing a Lamborghini mask :D

https://www.topgear.com/car-news/british/land-rover-has-deployed-27-new-defenders-battle-coronavirus
 
Heardy said:
What knock on effects are you thinking of? Economic / mental health & wellbeing?
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All of those. Long term people left without jobs or income who were already near the mark.

Short term, people struggling to get basic needs such as food. People not getting basic care and being forced to stay indoors or self isolate. People dying of other illnesses or conditions which could be due to a lack of care or lack of regular activity, or mental stress caused by any of the thousands of things a lockdown affects. Relationships put under strain, etc.

It really does add up very quickly, and this is a more extreme circumstance that we've seen before. If the government haven't considered it at all then it's very likely to overshadow the virus itself in the medium and long term.
 
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