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

Pogue Mahone

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I'm not sure there is an NHS wide policy to be honest. Sometimes the approach seems to differ to some extent based on the circumstances and team, even within the trust.

Roughly though, as long as you're wearing 'adequate PPE' (which by pitiful PHE standards is a surgical face mask, an apron and gloves) and haven't performed an AGP procedure, then you're fine with regards to carrying on with work.

We did have a heart sink moment about a month ago though when a patient arrested and the entire junior team were in there doing CPR etc.....only to find out that the patient had been Covid positive in the community about 11 days previously. Until her result ended up coming back negative at the hospital, we were discussing whether everyone would have to isolate, whether they'd come in and do daily lateral flows with 2-3 PCR tests over a month etc etc.

Will be interesting to see what they say for it soon.
Interesting. Thanks. So if you’re a fully vaccinated doctor/nurse and one of your kids tests positive you still have to self-isolate? Or if the app pings you after a night out? That’s going to cause havoc over the next few months.
 

GlasgowRedz

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Interesting. Thanks. So if you’re a fully vaccinated doctor/nurse and one of your kids tests positive you still have to self-isolate? Or if the app pings you after a night out? That’s going to cause havoc over the next few months.
Not as of the 16th of August as far as I'm aware (in England anyway)

Double vaccinated people won't have to isolate after this date even as a close contact.

Main gripe at the moment is the gap between the opening up on 19th July and the date this comes into effect
 

africanspur

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Interesting. Thanks. So if you’re a fully vaccinated doctor/nurse and one of your kids tests positive you still have to self-isolate? Or if the app pings you after a night out? That’s going to cause havoc over the next few months.
I believe so, though sometimes management gets involved and asks if perhaps you're asymptomatic, whether you can think about coming in and doing daily lateral flows/ isolating if you show symptoms etc.

I wonder whether more trusts will move to that kind of hybrid approach to try to avoid the mass isolations of the first wave.

One of the few good changes I hope comes out of this in the medical field is that we start treating our own staff with more care and dignity. For a profession supposed to be caring, we don't half run each other into the ground and treat any illness as some kind of weakness. The attitude of you should come in regardless needs to change.
 

Pogue Mahone

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I believe so, though sometimes management gets involved and asks if perhaps you're asymptomatic, whether you can think about coming in and doing daily lateral flows/ isolating if you show symptoms etc.

I wonder whether more trusts will move to that kind of hybrid approach to try to avoid the mass isolations of the first wave.

One of the few good changes I hope comes out of this in the medical field is that we start treating our own staff with more care and dignity. For a profession supposed to be caring, we don't half run each other into the ground and treat any illness as some kind of weakness. The attitude of you should come in regardless needs to change.
So true. I have so many memories of various poor bastards on call absolutely wrecked with viral illnesses but turning up anyway because they’d be shitting on their colleagues otherwise. An absolutely crazy situation thinking back to it.
 

africanspur

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So true. I have so many memories of various poor bastards on call absolutely wrecked with viral illnesses but turning up anyway because they’d be shitting on their colleagues otherwise. An absolutely crazy situation thinking back to it.
Yep horrific. I was reading of an O&G trainee who left medicine permanently relatively recently after her consultants and managers gave her a torrid time for having hyperemesis gravidarum when she was pregnant. Imagine! From O&G no less. You'd think of all the specialties they would be most sympathetic to a pregnant woman's plight.

Instead, she got a whole load of you're letting the team down, you're letting your patients down, are you resilient enough for medicine, why don't you just get a shot of anti-emetic and then come to work anyway, why don't you go vomit in between seeing patients.

Bunch of cnuts.
 

jojojo

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Experts...remember them?

Experts sign letter condemning Government’s ‘dangerous and unethical experiment’

https://www.itv.com/news/2021-07-07...overnments-dangerous-and-unethical-experiment
Well yes, and I agree with them that it's a massive public health gamble. The question is whether it's a bigger gamble to do it one hit through summer, or a whole string of hits over the next 12 months.

The modelling said that delaying the changes by a month (from June until July) would save lives and protect hospitals because of the need for second doses in the 40+ and at least first doses in the over 18. The answers are a lot less clear cut when you look at delaying until late August (second doses complete) or September when the kids go back to school and students return to college.

Obviously there's a question of whether we can vaccinate ourselves through it further (reducing case numbers and saving some people from illness and death) by vaccinating the 12-18s and giving booster shots to the oldest/highest risk.

I'm speaking as someone who could happily live with the current restrictions/guidance for the rest of the year (though I hate the travel restrictions). However I can see that a lot of people have already stopped following the rules, and the businesses who are still shut etc are hurting.

I would like them to continue some mitigations for longer - so the at risk can still do the essentials rather than go back into lockdown. I'd like to see masks on public transport, essential shops and similar places for example. And personally, I'll be more willing to go to a pub/restaurant saying they'll stick to current distancing and table service arrangements - so I'm hoping that some of them will do it.

In terms of what's going to happen though. Like they say, this is a massive gamble and all the stats/models are on a knife edge right now. It's going to be a massive gamble whenever it happens in terms of where it leaves the unvaccinated and the vulnerable though.
 

Dan_F

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Argh that's annoying :(

Trust this to fecking happen when England are on the verge of a Euro final!!
I’d imagine there will be a lot of people who went to last nights game, and planning to go to the final, who get pinged by Saturday.
 

Wolverine

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Interesting. Thanks. So if you’re a fully vaccinated doctor/nurse and one of your kids tests positive you still have to self-isolate? Or if the app pings you after a night out? That’s going to cause havoc over the next few months.
My experience is junior doctors (house officers and middle grades) asked to take daily lateral flow tests and don't need to self-isolate unless symptomatic. Not sure regarding nurses, HCAs etc. Based on what I've read online forums for HCPs, huge variation in interpretations.

That's based on my hospital locum post. In my GP practice, its working from home doing virtual clinics and isolating. But that's through community spread, hospital wise as long as PPE worn then its usually LFTs and ignore.

Consultants have managed to get 10 days isolation though. And I don't know about other trusts and what policies are.
 

Wolverine

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Yep horrific. I was reading of an O&G trainee who left medicine permanently relatively recently after her consultants and managers gave her a torrid time for having hyperemesis gravidarum when she was pregnant. Imagine! From O&G no less. You'd think of all the specialties they would be most sympathetic to a pregnant woman's plight.

Instead, she got a whole load of you're letting the team down, you're letting your patients down, are you resilient enough for medicine, why don't you just get a shot of anti-emetic and then come to work anyway, why don't you go vomit in between seeing patients.

Bunch of cnuts.
They've treated us like shit. My wife is in third trimester around 30 weeks and still patient-facing and doing surgery as a derm registrar despite RCOG and occu health advising against (she chose to get double vaccinated despite confirmation of pregnancy after discussion, but they're treating her to say she's low risk). She's on daily promethazine for hyperemesis as well and has had two hospital admissions as needed IM. Also physio due to sacroilitis from doing long complex physically taxing surgeries

We would get BMA/ACAS involved but she didn't want to kick up a fuss in case it has implications for her future and being seen as "difficult" by the managers
 

Sparky Rhiwabon

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groovyalbert

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Have schools now closed in Scotland? Interesting how their numbers are plummeting whilst England's grows.

Is there a potential Euros correlation? After last night/if England wins, it's going to be crazy this weekend.
 

Pexbo

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Whitty and Valance, the Kings of all Experts, had the chance to express disagreement with the plan on National TV at the press conference and didn’t, that’s good enough for me.
They did. They said the regulations were political decisions and not necessarily based on their recommendations.
 

jojojo

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Have schools now closed in Scotland? Interesting how their numbers are plummeting whilst England's grows.

Is there a potential Euros correlation? After last night/if England wins, it's going to be crazy this weekend.
Schools have closed in Scotland - which may have reduced the number of asymptomatic/low symptom cases being spotted in the U18s.

I'm not sure I'd describe their case numbers as plummeting though. From what I've seen the rates are very high in Scotland but have levelled out in recent days, which is a good sign. The Euros did give their numbers a huge kick upwards though, and the growth in the case numbers slowed again when the Scotland team got knocked out. Hopefully, as in the north west the curve may now be turning in Scotland and we'll see cases start to fall rather than just not rising as fast.


Current numbers/trends:
https://coronavirus.data.gov.uk/details/cases?areaType=nation&areaName=Scotland
 

BlueHaze

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My test came back negative, and I have no desire to get that swab stuck back up my nose to confirm but I definitely have it.
No blocked nose and I have COMPLETELY lost smell, it is the worst ever, I can't enjoy a meal, it's depressing. How long did it take for you to get it back? How long for others who've had it?
I don't know how much longer I can take this, I love my food and not being to enjoy it is utterly depressing. I'd rather have the body pains and other stuff that to lose my smell and partially taste.
Lucikly for me the loss of taste and smell only lasted roughly 2 weeks. A friend of mine went around with it for months. Now this indian variant is taking over and I'm honestly worried what direction this world is heading in. Vaccination has gone on for a pretty long while now and it's still spreading like hayfire and people are stil dying like flies.

Sadly this is going to be a part of the modern age. Worse things than covid will come. It's a mad era to live in. I've already lost my mother to MS 2 years ago and my old man has diabates and heart problems. People all across the globe are suffering from this and it's incredibly stressful. I wish everyone on here good luck and to stay safe.
 

cyberman

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My test came back negative, and I have no desire to get that swab stuck back up my nose to confirm but I definitely have it.
No blocked nose and I have COMPLETELY lost smell, it is the worst ever, I can't enjoy a meal, it's depressing. How long did it take for you to get it back? How long for others who've had it?
I don't know how much longer I can take this, I love my food and not being to enjoy it is utterly depressing. I'd rather have the body pains and other stuff that to lose my smell and partially taste.
Mine lasted about 6 weeks. I had no covid symptoms but i opened a bag of crisps and complained to the GF about it being a stale bag. She didnt think so but got another strong flavour bag to test it. Not a thing. Tried those gimmick strong sour ball sweets where my eyes watered but tasted nothing.
WHO should put that on their recommended test methods.
 

horsechoker

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Feeling less and less like light at end of tunnel but just another partially open summer before another winter lockdown.
 

stw2022

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With the majority of cases of those requiring hospital treatment being largely confined to the most vaccine resistant sections of society for virus that would ordinarily be affecting older people much more than it now is, the scramble to find Tweets that cast doubt on the effectiveness of the vaccines is odd
 
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Pogue Mahone

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With the majority of cases of those requiring hospital treatment being largely confined to the most vaccine resistant sections of society for virus that would ordinarily be affecting older people much more than it now is, the scramble to find Tweets that cast doubt on the effectiveness of the vaccines is odd
What are you talking about? What scramble? There’s been some studies published this week showing reduced effectiveness after single dose (or prior infection) but what’s that got to do with Twitter? At this stage it’s obvious that vaccines are less effective against Delta than they are against prior variants. Far too much data now available to assume otherwise. We’ve even had fully vaccinated people posting in this thread talking about catching covid!
 
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jojojo

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A graph for the geeks (it uses log scale to emphasise the doublings of risk as you go through the age group). As almost all these deaths are pre-vaccine, it's a startling story of how strong the correlation for age related risk is.

Something to note, men are effectively 5 years older than women when it comes to the death rates. Even so, a smaller percentage of men are getting vaccinated - which is a particularly risky act for the 40+ (fortunately the 70+ seem to have decided to get vaccinated)


 

FootballHQ

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Whitty and Valance, the Kings of all Experts, had the chance to express disagreement with the plan on National TV at the press conference and didn’t, that’s good enough for me.
They've disagreed with plenty of decisions the government have taken (were both pushing for two week circuit break last September) and probably raised those concerns behind closed doors. Whitty just saying no comment when asked about Cummings this time last year or whenever it was shows he's not interested in creating conflict in public way.

In fairness he's also consistantly said at the press conferences last few months eventually we'll have to learn to live with the virus.

Good some restrictions are being lifted but feels like too much is being lifted all at once rather than gradual steps, amazed we're going to get full football stadiums again next month for instance.
 

Wolverine

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Thought this was excellently well argued against main government talking points.
 

Brwned

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I hope that anchor was just playing devil's advocate there and isn't actually that thick.
Well the idea of playing devil's advocate is to make it difficult for the person to make their argument, so unless she was doing some kind of reverse psychology where she was intentionally making stupid arguments that boost the strength of the other person's argument...I think she was just being a bit brainless. Reading from a script without actually listening to what the other person's saying or even thinking much about what the script even says.

Agree Deepti made a very good case. I don't think it helps to make alarmist points about children - they pull at the heart strings, but they don't dive with the evidence - but she did a good job of ridiculing the false dichotomy. Though I suspect the people who buy into it don't really listen to opposing arguments anyway...
 

Pogue Mahone

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Thought this was excellently well argued against main government talking points.
She’s quite annoyingly negative on Twitter and seems overly obsessed with long covid but hard to argue with anything she says here. The “what about cancer patients” argument is infuriating.

Is it correct that only 50% of the UK are fully vaccinated? That seems very low? We passed that milestone last week in Ireland and we’ve consistently been miles behind the UK in our roll-out.
 

Pogue Mahone

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Well the idea of playing devil's advocate is to make it difficult for the person to make their argument, so unless she was doing some kind of reverse psychology where she was intentionally making stupid arguments that boost the strength of the other person's argument...I think she was just being a bit brainless. Reading from a script without actually listening to what the other person's saying or even thinking much about what the script even says.

Agree Deepti made a very good case. I don't think it helps to make alarmist points about children - they pull at the heart strings, but they don't dive with the evidence - but she did a good job of ridiculing the false dichotomy. Though I suspect the people who buy into it don't really listen to opposing arguments anyway...
Long Covid and children are her two pet topics to obsess about on Twitter. As usual I suspect heavy social media use is taking reasonable concerns and making them more extreme.
 

massi83

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She’s quite annoyingly negative on Twitter and seems overly obsessed with long covid but hard to argue with anything she says here. The “what about cancer patients” argument is infuriating.

Is it correct that only 50% of the UK are fully vaccinated? That seems very low? We passed that milestone last week in Ireland and we’ve consistently been miles behind the UK in our roll-out.
50% total population for UK. 50% of adults for Ireland.
 

africanspur

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She’s quite annoyingly negative on Twitter and seems overly obsessed with long covid but hard to argue with anything she says here. The “what about cancer patients” argument is infuriating.

Is it correct that only 50% of the UK are fully vaccinated? That seems very low? We passed that milestone last week in Ireland and we’ve consistently been miles behind the UK in our roll-out.
50% if including children (34.2 million out of a rough population of 68 million). 64.9% of adults have had both doses now, with almost 87% having received their 1st.
 

africanspur

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They've treated us like shit. My wife is in third trimester around 30 weeks and still patient-facing and doing surgery as a derm registrar despite RCOG and occu health advising against (she chose to get double vaccinated despite confirmation of pregnancy after discussion, but they're treating her to say she's low risk). She's on daily promethazine for hyperemesis as well and has had two hospital admissions as needed IM. Also physio due to sacroilitis from doing long complex physically taxing surgeries

We would get BMA/ACAS involved but she didn't want to kick up a fuss in case it has implications for her future and being seen as "difficult" by the managers
Sorry to hear that buddy, they really are twats and often have such little care for their staff.

Hope you guys get through it all OK and its over soon. They still haven't quite clocked one of the major reasons for physician burnout and dropout rates it seems.
 

Wolverine

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She’s quite annoyingly negative on Twitter and seems overly obsessed with long covid but hard to argue with anything she says here. The “what about cancer patients” argument is infuriating.

Is it correct that only 50% of the UK are fully vaccinated? That seems very low? We passed that milestone last week in Ireland and we’ve consistently been miles behind the UK in our roll-out.
Agreed. Prof Pagel is a lot more measured and less hyperbolic.

I'm undecided on vaccinating kids, I think I see it more from the POV of the NEJM study saying that its safe, also licensed for teenagers. More from reducing community infections, breaking off chains etc.

Long covid is a huge, poorly understood spectrum of disease. I'm following up a number of patients with suspected long covid who've we've referred for CT scans, spirometry, chest physios and to long covid clinics for a case study type of thing because we had loads in inner city Leicester with additional surveys to identify how debilitating it is generally.

Generally its sort of like fibromyalgia but without the pain relief requirements, more intermittent breathlessness, muscle fatigue predominant in my experience. Actually was worse in first wave when we had really worrying-sounding chest pains in a significant number (with investigations all normal). Some good response to bronchodilator trials and dealing intercurrent deficiencies in vitamin D. But huge variation in clinical presentation and mostly its persistent post-viral like symptoms now. Many have been phased back into work gradually to even physically exerting role.

I don't really buy the stats on its prevalent and without wanting to downplay its debility or extent, I don't think thats the argument for postponing restriction-lifting vaccinating more, and vaccination the teens.

There's enough of a case from preventing community transmission towards elderly/immunocompromised and preventing variants.

But I agreed with what most of what she said in there. The bizarre lifting of mask mandate is worrying to me. And also points to governments actually wanting this thing to spread to some extent.
 

Pogue Mahone

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Agreed. Prof Pagel is a lot more measured and less hyperbolic.

I'm undecided on vaccinating kids, I think I see it more from the POV of the NEJM study saying that its safe, also licensed for teenagers. More from reducing community infections, breaking off chains etc.

Long covid is a huge, poorly understood spectrum of disease. I'm following up a number of patients with suspected long covid who've we've referred for CT scans, spirometry, chest physios and to long covid clinics for a case study type of thing because we had loads in inner city Leicester with additional surveys to identify how debilitating it is generally.

Generally its sort of like fibromyalgia but without the pain relief requirements, more intermittent breathlessness, muscle fatigue predominant in my experience. Actually was worse in first wave when we had really worrying-sounding chest pains in a significant number (with investigations all normal). Some good response to bronchodilator trials and dealing intercurrent deficiencies in vitamin D. But huge variation in clinical presentation and mostly its persistent post-viral like symptoms now. Many have been phased back into work gradually to even physically exerting role.

I don't really buy the stats on its prevalent and without wanting to downplay its debility or extent, I don't think thats the argument for postponing restriction-lifting vaccinating more, and vaccination the teens.

There's enough of a case from preventing community transmission towards elderly/immunocompromised and preventing variants.

But I agreed with what most of what she said in there. The bizarre lifting of mask mandate is worrying to me. And also points to governments actually wanting this thing to spread to some extent.
Completely agree with your take on long covid. The bottom line is that post viral morbidity has been around forever and the harder you look for it the more you’ll find. We’ve never used it as a reason to take extreme measure to prevent the spread of, say, influenza so it shouldn’t be a big factor in any decisions we take about covid now. All this talk about “an epidemic of long term disability” is silly.

It’s not as though we need any more reasons to try and control the spread of this damn thing anyway!
 

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I hope that anchor was just playing devil's advocate there and isn't actually that thick.
Embarrassing line of questioning, probably devised by someone with no basic grasp of epidemiology.

Glad the lady very clearly called out the false dichotomy peddled by the govt.
 

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It took just 2 weeks of relaxation to start closing again in NL. R rate now 1.37, pubs to shut at 12 and clubs to close completely. Infections increased 10 fold in a week and the under 30s the only group on the rise in infections even though 15 year olds can get jab now.
 

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Is there any link to rise in cases to the nations that have made it to the semis in the football, Spain,Italy,Denmark and England?