China Coronavirus

[Taylor]

Wuhan relaxed its lockdwn this week after 11 weeks, so still a bit to go for us.

Wuhan has 11 million odd people in it and was the centre of the outbreak though. By density and geography (Lack of Chinese New Year movement also) you'd hope that we can avoid what other countries are experiencing by comparison.

Are we at the point were the impact of Cheltenham and not stopping flights from the likes of Italy (cancelled rugby match) is starting to hit?

Has to have had some sort of impact for sure - similarly Liverpool area had a spike in cases due to the Athletico fans attending a game.

In addition to this our airports are still open with minimal screening 

Still open? I take it that's just to bring back the stranded? I'm sure most of them would have been home by now or stayed?

Though I'd imagine they would have to self isolate for 2 weeks on arrival

They should be taken to self isolate somewhere - assume it is just advice at this stage

[Rois]

Why is age being used as a reason?

I assume it is supposed to be loosely based on chances of survival.  I just don't know what evidence there is to support it.
   

[armaghniac]

The ventilator age limit in the north is/will be 70.  Frightening, when I consider that my parents are past that limit.

Where did you get that from?

One of wives friends is ICU - and I'd heard via that it was 58... 

It may have been as low as 58 in Madrid or Bergamo, or now in New  York. It isn't  that bad here, thanks be to God.

[seafoid]

https://www.bbc.com/news/av/world-middle-east-52189059/coronavirus-israel-s-ultra-orthodox-lockdown-challenge

[Milltown Row2]

Why is age being used as a reason?

I assume it is supposed to be loosely based on chances of survival.  I just don't know what evidence there is to support it.
   

I suppose there is no proper solution for choosing, I can't honestly think of a fair call, and the guilt that a doctor will have on their minds is terrible.  Sophie's choice scenario!

[RadioGAAGAA]

The ventilator age limit in the north is/will be 70.  Frightening, when I consider that my parents are past that limit.

Where did you get that from?

One of wives friends is ICU - and I'd heard via that it was 58... 

The font of all knowledge for me on this - my sister (consultant in the Ulster but not in ICU, taking part in daily briefings on it but perhaps a day behind).  I thought 70 was scary enough, but 58...

I have to admit, I was pretty sceptical that the missus was picking it up right (wouldn't be the first time!)

I would have thought age/requirements would get worse depending on demand and initially would have started very high, if not unlimited.

[RadioGAAGAA]

Why is age being used as a reason?

I assume it is supposed to be loosely based on chances of survival.  I just don't know what evidence there is to support it. 

I suppose there is no proper solution for choosing, I can't honestly think of a fair call, and the guilt that a doctor will have on their minds is terrible.  Sophie's choice scenario!

I'd have thought its best for the medics on the scene if the decision making process is as tickbox as possible.

It would offload as much of the responsibility as possible from those actually in the wards/ICUs - crap for the patient but might stop the medics from breaking down (now and/or later).

One of those rare instances where "computer says no" is perhaps the lesser of two evils.

[LeoMc]

The ventilator age limit in the north is/will be 70.  Frightening, when I consider that my parents are past that limit.

Where did you get that from?

One of wives friends is ICU - and I'd heard via that it was 58... 

The font of all knowledge for me on this - my sister (consultant in the Ulster but not in ICU, taking part in daily briefings on it but perhaps a day behind).  I thought 70 was scary enough, but 58...

Why is age being used as a reason?

I think it is down to years left to live if saved. According to the BMA where resources are scarce it is ethical to take the ventilator and give it someone with a better prognosis!! 

....If they become necessary, these decisions must not be solely based on age. Ethically, triage requires identification of clinically relevant facts about individual patients and their likelihood of benefiting from available resources. Younger patients will not automatically be prioritised over older one.....

..... A healthy 75-year-old cannot lawfully be denied access to treatment on the basis of age. However, older patients with severe respiratory failure secondary to COVID-19 may have a very high chance of dying despite intensive care, and consequently have a lower priority for admission to intensive care....

https://www.bma.org.uk/media/2226/bma-covid-19-ethics-guidance.pdf

[Milltown Row2]

Why is age being used as a reason?

I assume it is supposed to be loosely based on chances of survival.  I just don't know what evidence there is to support it. 

I suppose there is no proper solution for choosing, I can't honestly think of a fair call, and the guilt that a doctor will have on their minds is terrible.  Sophie's choice scenario!

I'd have thought its best for the medics on the scene if the decision making process is as tickbox as possible.

It would offload as much of the responsibility as possible from those actually in the wards/ICUs - crap for the patient but might stop the medics from breaking down (now and/or later).

One of those rare instances where "computer says no" is perhaps the lesser of two evils.

So there is no government guidelines on this? Purely on the advice medics on the scene?

[armaghniac]

55 for smokers, 75 for normal people.

[LeoMc]

55 for smokers, 75 for normal people.

Normal?

..... A healthy 75-year-old cannot lawfully be denied access to treatment on the basis of age. However, older patients with severe respiratory failure secondary to COVID-19 may have a very high chance of dying despite intensive care, and consequently have a lower priority for admission to intensive care....

https://www.bma.org.uk/media/2226/bma-covid-19-ethics-guidance.pdf

[Tony Baloney]

It's basic triage - focus on those who need help and are likely to make it. Even a first aider has to do it in extreme circumstances e.g. in a traffic accident.

[RedHand88]

55 for smokers, 75 for normal people.

They should print that on feg packets.

[RadioGAAGAA]

Why is age being used as a reason?

I assume it is supposed to be loosely based on chances of survival.  I just don't know what evidence there is to support it. 

I suppose there is no proper solution for choosing, I can't honestly think of a fair call, and the guilt that a doctor will have on their minds is terrible.  Sophie's choice scenario!

I'd have thought its best for the medics on the scene if the decision making process is as tickbox as possible.

It would offload as much of the responsibility as possible from those actually in the wards/ICUs - crap for the patient but might stop the medics from breaking down (now and/or later).

One of those rare instances where "computer says no" is perhaps the lesser of two evils.

So there is no government guidelines on this? Purely on the advice medics on the scene?

No no, we're crossing wires - I'm saying there is, or should be at least, strict guidelines.

Hence whoever is on the scene runs down their tickboxes and the result of that says ye or ne on a ventilator. Would be easier mentally for the doc/nurse on scene if the decision is removed from their hands as much as possible.

[Itchy]

This could be a massive help if it proves out...

https://www.independent.ie/world-news/coronavirus/q-and-a-tb-vaccine-may-boost-the-bodys-immune-system-to-fight-coronavirus-39112346.html

I know I got the vaccine, and everyone* that is older than 5 also got it (*except those idiotic tin foil hat anti-vax crowd).

I've been thinking about the exit strategies available to governments and its clear there are none to appealing but this might just be the thing that is needed.