Doctoroncall

It’s a shame the thread has been reduced to point scoring. It hasn’t been confirmed. It can take 1-3 weeks to form antibodies. No one knows if immunity is short term only. More studies are needed. It’s must likely those infected can have a relapse. The virus has been found in swabs from throats four weeks later.

I wouldn’t say that. It’s the not knowing which causes most concern. We are at war, people need to be mobilised to do the right thing and there is always going to be risks in any strategy/policy. This from a Aussie critical care director which puts it in perspective of the knock on effect this virus will have: In Australia, Dr Adam Visser, the director of critical care at Toowoomba hospital in regional Queensland, has posted an impassioned plea for the Australian community to take individual action to help “flatten the curve” and keep intensive care units from being overwhelmed by Covid-19 cases. I’m an intensive care specialist in a small city. Coronavirus isn’t just like the flu, but it’s only really very dangerous to the elderly or the already unwell. Quite a lot of people in their 80s will die, but most of the rest of us will probably be OK. If you’re in your 70s and you get Coronavirus, you’ve got a really good chance of survival. If I’ve got a bed for you. If you’re in your 60s and you have a heart attack, you’ve got a really good chance of survival. If I’ve got a bed for you. If you’re in your 50s and need bowel cancer surgery, you’ve got a really good chance of survival. If I’ve got a bed for you. If you’re in your 40s and have a bad car accident, you’ve got a really good chance of survival. If I’ve got a bed for you. If you’re in your 30s and have terrible pre-eclampsia as a complication of pregnancy, you’ve got a really good chance of survival. If I’ve got a bed for you. If you’re in your 20s and have a bad reaction to a party drug, you’ve got a really good chance of survival. If I’ve got a bed for you. I have 7 beds equipped with life support machines. We have a plan to increase to about 25. Getting more isn’t a matter or more equipment or more money, that bit is easy. There are not enough skilled staff, even if we all work double shifts every day for six months (and we probably will). If 50% of my city gets infected, that’s 75,000 people. If 5% of them need life support (which is the estimate), that’s 3750 people. For 25 beds. And then I might not have a bed for you. So it’s up to you to flatten the curve. Wash your hands. Stay home. It’s important to remember that the 3750 projected cases will not happen at the same time but it illustrates the risks to people with other medical conditions and the importance to flatten the curve considering the resources available.

It’s not all about science but executing a plan of action with many stakeholders. The biggest of which are the people. There are many others from supermarkets, schools, HCPs, local authorities, labs, medical kit manufacturers, etc etc. It seems not many know what to do hence you are seeing businesses and organisations dictating policy to protect their workers (and hence their business).

Hundreds of members of the scientific community have sent two open letters to the British government, voicing their concerns about the government’s response to the coronavirus outbreak. One comes from 198 academics in the field of maths and science , calling for urgent measures of social distancing across the UK. It says: “Going for “herd immunity” at this point does not seem a viable option, as this will put NHS at an even stronger level of stress, risking many more lives than necessary.” Another letter has been signed by 164 behavioural scientists. It raises concerns about the idea of ‘behavioural fatigue’ - the idea that if the public are instructed to take preventative measures too early, they’ll eventually revert back to prior behaviour. The letter suggests that this has been a cornerstone of British government policy on coronavirus and sheds doubt on the evidence behind this. “While we fully support an evidence-based approach to policy that draws on behavioural science, we are not convinced that enough is known about “behavioural fatigue” or to what extent these insights apply to the current exceptional circumstances,” it says. “If “behavioural fatigue” truly represents a key factor in the government’s decision to delay high-visibility interventions, we urge the government to share an adequate evidence base in support of that decision. If one is lacking, we urge the government to reconsider these decisions,” it ends.

Ideally, yes it would be great to be able to monitor the infections however practically this is very difficult to do on a continuous basis in this phase (test kits availability and resource to obtain results) so the priority are for hospitals, vulnerable and HCPs so immediate response can be initiated. It is a risk and they are probably relying on the modelling and forecasts to help predict if other measures need to be introduced. Hopefully there will soon be kits available to test for antibodies. The antibodies typically appear in the blood one to three weeks after infection. China may already have them and they will be a big help.

If only they showed another graph to indicate what they are trying to do, it would be easier to understand although a bit macabre in pursuing a solution to creating infections (but also immunity) in the community. As currently there is very little immunity in the community and a vaccine is at least a year away the best practice is to lessen the gradient of the curve so NHS can cope better and society can still function as best it can. Where it has gone out of control like northern Italy where infections have ran out of control there is too much strain on HCPs and services. The other aspect to avoid is a second wave. It’s all very well for a country to have a lockdown as an immediate reaction but if it gets to the stage where there is little immunity in the community - how do you return to normal activities, trade, tourism etc? The lock down will have to last until there is a vaccine or the infection could be back so it is better to manage the rate of infections from the beginning until there is the natural immunity in the community and the focus can be on the care of the vulnerable and HCPs.

Median incubation period is five days. The time from exposure to onset of infectiousness may be shorter than the incubation period. An analysis of infections in Singapore and Tianjin in China revealed that two-thirds and three-quarters of people respectively appear to have caught it from others who were incubating the virus but still symptom-free.

Taiwan suffered badly with SARS and learnt from it. Have implemented an aggressive lock down plan at the start of latest Coronavirus outbreak, and have been successful in combating the spread and containing the virus. Could the UK succeed with the same plan? - it needs 100% cooperation and compliance to work.

UEFA will have a cunning plan - no handshakes! Next season new rules will include players to remain at least 1.5m from each other and no running.

Solid vaccines are hard to administer. Nice to see someone giving him an out by saying probably! Lol.

A-C (they are all shady) or the Brentford type with analysis behind player buys and a strong academy with a good manager.

Not really - it’s how well the club has spent considering the money is limited. All under his leadership.

It’s yours to lose with one game to go!

No. The virus that causes COVID-19 is similar to the one that caused the 2003 SARS outbreak: both are types of coronaviruses. Much is still unknown, but COVID-19 seems to spread faster than the 2003 SARS and also may cause less severe illness.

You mean they are now doing it properly!

There are two known strains, the rest of what you say is unproven and just speculation. https://academic.oup.com/nsr/advance-article/doi/10.1093/nsr/nwaa036/5775463

If you know your phylogeny then this site is useful in understanding the different types and mutations: https://www.gisaid.org if you don’t this is a straightforward article: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30374-3/fulltext . Within COVID-19 there are mutations but are similar in type as seen here - http://www.gisaid.org/epiflu-applications/next-sars-cov2-app You’ll see bat and pangolin are noted but all infections listed are human to human. If you want latest numbers - http://www.gisaid.org/epiflu-applications/global-cases-covid-19/ Hope that is of interest to you.

The trouble is nobody knew about this virus two months ago, it was entirely unknown. Only now are results from studies coming out: severity increases with age, 81% of known infections can be classified as mild and 2.3% result in death. Viral shedding studies should tells us about the condition of a person in spreading the virus (no symptoms to severe). Duration of incubation period between infection and symptoms is unknown - that will help define quarantine time. Learning lessons from Ebola, SARS, MERS and avian flu there is more concerted effort to be better prepared- two weeks ago only SA and Senegal in Africa had labs that could test for the virus, now 27 countries have the test kits and are using them. All info from The Lancet - Scientists are sprinting to outpace the novel Coronavirus if anyone is interested.

Depends what combo of treatments they are taking. Some could be potential treatments for Coronavirus as they disrupted the RNA replication.

It would be fantastic to get into Europe from having the start we’ve had this season. Just thinking back to the Everton game gives me the shivers. It’s a long shot with so many teams above us, but it’s been a funny old season. I don’t understand why anyone would not want the team to excel.

Ha! An examiner incorrectly crossed affect out and replaced it with effect on my thesis. Misplaced apostrophes or a case just stick one in for good measure.

Michael Owen and Phil Neville would an insomniac’s dream team.

Anwar El Ghazi

It’s like going to a football match and not backing your team.

The physioroom is a reasonable resource for injury status. Redmond out for minimum of a month. Boufal no return date set.