Really. You work in healthcare, right? Are you seriously suggesting that neither you no any of your colleagues had the faintest idea the ICUs were working at near capacity before the pandemic? — Isaac

At my hospital they stopped doing elective surgeries during the blitz and devoted surgical ICUs to COVID. We just started doing that again. Space isn't an issue for us because we're gigantic. Staffing limits our capacity. That's true across the country.

Did you all look at your stock of ventilators and think "plenty there to handle a pandemic"? Di — Isaac

Ventilators aren't an issue any more. We try to stay on a high flow O2 delivery system. Get people to self-prone. We're prepared to use our ventilators as high flow devices, but we haven't needed to yet.

This is one of the problems with trying to prepare for a pandemic. You can stock basics (although we use plastic, which means all that stuff has expiration dates), but we learn from the disease what we need in terms of supportive equipment. If ebola evolved into something less deadly and more transmissible, we don't know if we would need ventilators. We'll have to find out if it happens.

Yeah I know. A multinational conglomerate that has a documented history of lying about its products, plans to make billions out of injecting half the world with a chemical that's had one tenth of the testing and one fiftieth of the approval checks given to medicines normally administered to less than one thousandth of the target population, to alleviate the spread and hospitalisation rate of a virus despite no evidence whatsoever that it will do either, and despite knowledge of proven alternative approaches which are cheaper and will definitely do both. And I'm bothered about it. I guess I'm just funny like that. We all have our quirks I suppose. — Isaac

So this is mostly wrong, but I've talked to you about it before, and I don't see any reason to go through it again.

At my hospital they stopped doing elective surgeries during the blitz and devoted surgical ICUs to COVID. We just started doing that again. Space isn't an issue for us because we're gigantic. Staffing limits our capacity. That's true across the country. — frank

So, yes then. You were at capacity. It doesn't matter if it's staff, space, equipment, or specialists. The details are not the point. The working to capacity is. Maybe the nature of the capacity is different in America (over here it's all four), but the point of being at or near capacity in some respect is all that's relevant.

You can stock basics (although we use plastic, which means all that stuff has expiration dates), but we learn from the disease what we need in terms of supportive equipment. — frank

No. You can stock anything and replace it at expiry if need be. Again, the details aren't the point.

If ebola evolved into something less deadly and more transmissible, we don't know if we would need ventilators. We'll have to find out if it happens. — frank

Not if you paid for an emerging disease monitoring service, had an efficient manufacturing chain on standby, had excess staffing in both medical services and medical supply services, had a contingency plan to cover all this (oh, and avoided having a clown for a president). Then you might stand a chance of finding out just before it happens (in your country).

So this is mostly wrong, but I've talked to you about it before, and I don't see any reason to go through it again. — frank

No, you spouted off a load of ad hoc guesswork without a single citation to support your assertions, whilst I posted papers from the bmj, the lancet and the manufacturers own testing facilities...is actually what happened.

Not if you paid for an emerging disease monitoring service, had an efficient manufacturing chain on standby, had excess staffing in both medical services and medical supply services, had a contingency plan to cover all this (oh, and avoided having a clown for a president). Then you might stand a chance of finding out just before it happens (in your country). — Isaac

Yes, the US screwed up. Thanks for letting me know.

@frank
You my friend are not charged with taking any flack about how "we" handled it. As always, I believe we do the best we can until we know better. When we know better we do better.
You are an Angel that lacks recognition for having to sacrifice your own safety to help others.
It is not something that I will ever forget not take for granted.
Thank you for caring for those who need care. It's really that simple, Thank you from the bottom of my heart :heart:

I don't know what to say! Thank you. :hearts:

Another test. One case in Perth. Two million people locked down for five days.

My son had as homework in history a question if he has experienced a historical event. He immediately answered the Covid-19 pandemic and, as a 12-year old, was happy that he had experience something really historic in his lifetime.

Nothing to argue about there.

A pandemic with number of deaths in the top ten in all of history and with the lockdowns, political turmoil and the economy depression, this is surely something for the history books.

He immediately answered the Covid-19 pandemic and, as a 12-year old, was happy that he had experience something really historic in his lifetime. — ssu

Bit morbid, but since there's been a pandemic of greater than 1 million fatality about every fifty years since at least early nineteenth century, this is going to be the case for almost everyone.

...Oh no, I forgot. This came completely out of the blue, without precedent and there's nothing whatsoever we could have done in preparation. All those previous pandemics must have been something else.

Well, my father knew well the Hong Kong flu of 1968-1969, but he is a virologist. Otherwise it wasn't on the radar of people when thinking of the 1960's.

Prior to Covid-19 history books hardly ever mentioned the flu pandemic when talking about the tumultuous year of 1968. These prior diseases fell into the category of "nasty flus". The last pandemic that history books or school books mentioned was the Spanish flu.

These prior diseases fell into the category of "nasty flus". — ssu

Russian Flu, 1890, killed a million.
Spanish Flu, 1919, killed 50 million.
Asian Flu, 1957, another million.
Hong Kong Flu, 1968, another million.
HIV/AIDS from 1981, killed about 25 million so far
Swine Flu, 2009-2010, 200,000.
Covid-19, now, 1-2 million (depending on sources).

It's a completely predictable part of living so close together. That we weren't prepared is nothing short of criminal.

HIV/AIDS doesn't spread like a flu, and the only one obviously different is the Spanish Flu.

Let's remember the comparison, the one argument made many times at the outbreak of this pandemic:

Most years, the US death toll from the flu is closer to 34,000 to 43,000. Globally, the World Health Organization (WHO) estimates that the flu kills 290,000 to 650,000 people per year.

That we weren't prepared is nothing short of criminal. — Isaac

Think of it from another viewpoint: We had SARS, MERS, swine flu and an Ebola outbreak. And those were contained, even if Ebola caused much death in West Africa and did spread to the US. What I remember, a lot of people were making the alarms about them too.

I remember that the view was that it was "only a matter of time" that we would get a pandemic that wouldn't be so easy to contain. You can read dozens of articles and many documentaries that were done prior to Covid-19 warning about what could happen.

It's a completely predictable part of living so close together. That we weren't prepared is nothing short of criminal. — Isaac

Who are the criminals, the doctors, scientists, or those ignorant politicians? Maybe viruses are just too smart for us, they can mutate in a day but it takes the best science much of a year to fight back. Viruses aren't as smart as large asteroids or supervolcanoes but definitely smarter than global climate change.

You can read dozens of articles and many documentaries that were done prior to Covid-19 warning about what could happen. — ssu

My point exactly. Yet at the same time global monitoring programmes were being shut down, hospitals were being run to capacity, community healthcare facilities were being closed, public health initiatives underfunded, social care driven to near breaking point... all with a known public health threat just waiting to happen.

Who are the criminals, the doctors, scientists, or those ignorant politicians? — magritte

The population in general really. They vote for the politicians. The doctors and scientists were generally the ones telling everyone we need to be more prepared (though not exclusively). Being prepared costs money and effort - a few pence off the tax bill is ultimately a more attractive option - hence we get the politicians who promise that.

Maybe viruses are just too smart for us, they can mutate in a day but it takes the best science much of a year to fight back. — magritte

No it doesn't. This is just the Hollywood myth that's being peddled here. Read the actual scientists I've cited. Proven defences against viruses include - better quality social care, better public health, better urban environments, better primary healthcare facilities, better intensive care facilities, more availability of primary care, early and strict lockdowns, early closure of borders, efficient tracing of contacts, wearing masks, maintaining a social distance, hand washing...and most importantly, having a plan in place which includes these things.

None of that requires us to know the exact molecular signature of the virus concerned. There's only one response which requires that and that's the creation of a vaccine. Creating a vaccine is never, ever, going to be a first line of defence and so is completely irrelevant to the issue of preparedness.

Covid: Israel's vaccine rollout linked to infection fall

Well you'd f*cking hope so...

It is psychologically difficult for most to justify paying today for something that will be needed "in the future". Pair that with leaders who can't/won't lead and you get what you get.

My son had as homework in history a question if he has experienced a historical event. — ssu

How long do polar bears stay in touch with their offspring?

Another test. One case in Perth. Two million people locked down for five days. — Banno

It's worth noting that the state had been free of community transmission for ten months, and the rest of Australia currently has no known community transmission.

Here's an NYT article about it as well:

The lockdown in Perth and the surrounding area followed similar efforts in Brisbane and Sydney, where a handful of infections led to steep ramp-ups in restrictions, a subdued virus and a rapid return to near normalcy. Ask Australians about the approach, and they might just shrug. Instead of loneliness and grief or outcries over impingements on their freedom, they’ve gotten used to a routine of short-term pain for collective gain.
...
“We have a way to save lives, open up our economies and avoid all this fear and hassle,” said Ian Mackay, a virologist at the University of Queensland who developed a multilayered, or “Swiss cheese,” model of pandemic defense that has been widely circulated. “Everyone can learn from us, but not all are willing to learn.”
...
Australia’s geographic isolation offers it one great advantage. Still, it has taken a number of decisive steps. Australia has strictly limited interstate travel while mandating hotel quarantine for international arrivals since last March. Britain and the United States are only now seeking to make quarantine mandatory for people coming from coronavirus hot spots.

Australia has also maintained a strong system of contact tracing, even as other countries have essentially given up. In the Perth case, contact tracers had already tested the man’s housemates (negative so far) by the time the lockdown was announced and placed them under 14-day quarantine at a state-run facility. The authorities also listed more than a dozen locations where the security guard might have touched or breathed on someone.
...
Dr. Mackay, who has worked closely with Australian government officials, called it “the hammer and the dance.”
— One Case, Total Lockdown: Australia’s Lessons for a Pandemic World

Just as I predicted, the virus is no longer a hoax.

That's some cynical shit. The upside is their readers might start to take masks and social distancing seriously.

thoughts?
https://www.bndestem.nl/dossier-coronavirus/kabinet-treft-voorbereidingen-voor-verlengen-avondklok~a6f9cc9b/?fbclid=IwAR3gH_Q8digHX_JqIoWbn2MBE42E3T7dspbMZCpd2O0_DMQjbnDXMpqpuzo&referrer=https%3A%2F%2Fm.facebook.com%2F

It sucks that the only thing the English successfully exported since Brexit is a virus. I think the restrictions are necessary but like everything in the Netherlands too little too late. If 5,000 cases a day isn't good enough now, they never should've let it rise to 10,000 in the first place. If you worry about a more severe strain, you immediately should prohibit air travel. If numbers don't go down quickly enough, you immediately set a curfew. Instead every measure is taken a month too late. I don't see restrictions eased beginning of March either.

It's taking it's toll mentally and emotionally and it's not good for relationships to be in each other's face basically 24/7 for months on end.

Apparently Perth's lockdown worked. No new cases, lockdown finishes in a few hours.

this suggested surgical approach to covid policy makes a lot of sense to me

https://davidkatzmd.com/coronavirus-information-and-resources/

base restrictions on level of risk

anyone care to point to flaws in this approach?

I can;t see any and think it would work well, I don't see it ever actually being followed due to its complexity.

There's probably going to be different plans for different regions depending on local priorities and capabilities, heavy on the capabilities.

Apparently Perth's lockdown worked. No new cases, lockdown finishes in a few hours. — Banno

Yep. Australian states have a clear objective, which is to get community cases to zero and keep it that way. Then life returns to normal.

If they can improve hotel quarantine procedures, then they may be able to avoid the need for lockdown altogether. For example, to quarantine in less populated areas and/or have permanent on-site (or fly-in/fly-out) quarantine workers.

Quarantine workers are first in line for immunisation - which hasn't commenced yet...

The issue I foresee is a relaxation of restrictions during the long process of immunising the population. Given that there is so far little evidence of immunisations affect on the spread of the virus, I would not be surprised by further community transmission, especially as we move into winter.

It's been obvious for a few weeks that he UK variant is airborne; government officials are yet to acknowledge this, which I put down to the need for bureaucratic omnipotence: don't acknowledge a problem until you have at least an apparent solution.

anyone care to point to flaws in this approach?

I can;t see any and think it would work well, I don't see it ever actually being followed due to its complexity. — dazed

If a plan is complex, then it will have many potential points of failure. Consider a complex piece of software that has never been tested. Would you risk your life on it working?

In contrast, consider Australia's and New Zealand's COVID strategies. Those countries had a clear objective, which was zero community transmission. People understand the strategies needed to get there, and it has been demonstrated to work.

These countries adopted a precautionary strategy from the start, versus a "let's try what we think might work and see what happens" strategy. The latter is fine when people's lives and well-being don't depend on the plan working. But a precautionary strategy is necessary when they do. It's always possible to adjust that strategy as new data comes in, as Australia and other similarly situated countries are doing.

:100:

It's been obvious for a few weeks that he UK variant is airborne — Banno

The previous version is also airborne.

...not to the same extent, apparently.

It is likely that the frequency of such transmission is increased with the more transmissible strain.

https://www.abc.net.au/news/2021-01-16/hotel-quarantine-gap-prevent-airborne-spread-of-covid-19/13057644