Coronavirus and Audax

[Davef]

I’m an actuary, not an epidemiologist - although I nearly became one back in the day. We have similar and slightly overlapping skill sets.

I am being cautious. I have stopped riding my bike as I don’t want to be turned away from A&E if I have an off, but it turns out to be full. I expect that, all being well for me, I’ll start riding again towards the end of the year or into next year.

I understand the government strategy, although there is little detail of next steps apart from ‘leaks’ to Peston - a poor way of governing imho. I believe the strategy is a risky one and that, when this is past (could be a fairly long time) the impact and decision processes should be reviewed. We are stuck where we are.

There are a lot of factors here to think about, and only a few we can manage as individuals. What we can do is whatever we can to slow the spread and minimise the peak - that means limiting our social contact. The government policy to date hasn’t helped, because it makes working from home less easy than it might be for those that can and hasn’t set out how low paid workers will be supported. That may come.

One area that we don’t know is whether the modelling suggests that a very long spread would lead to more deaths overall as a consequence of the NHS being overwhelmed for 12-16 months rather than 3-4. It’s easy to assume economics has driven this just because we don’t like the government etc, but we don’t actually know.

 I am convinced that doctors will be presented with horrible choices to make about who gets treatment and that the aftermath will be one of shock for all those left. I think that will be a consequence of both the number of deaths that will touch the whole nation, and world, and the helplessness we face in dealing with numbers. That’s not anybody’s fault really and I will be the first to say that I wouldn’t want to be in the prime minister’s shoes at the moment.

Be kind to each other.

My understanding is the intention is to have a peak in 10 to 11 weeks time so that we are into the long tail before the next seasonal flu season starts. The peak has to be flat enough not to overwhelm nhs but not too flat for the isolation of vulnerable people to be too long (12 weeks is deemed acceptable). The timing of announcements will be designed to keep the rate just right, not too high and not too low.


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[andyoxon]

If we all stick to challenging people's attitude, and remember they are challenging our attitude, then no need to get personal or abusive...

The attitude I'd like to challenge is:

  "It has not happened here / to me,
  therefore it might never happen,
  therefore I should carry on as normal (within the law),
  and NOT panic!"


IMO that is bound to speed the spread of the virus, compared to:

  "I'm not going to take any unnecessary risks, to my health or that of others."

Is all cycling carrying an 'unnecessary risk', with the impending clinical crisis then?

[mzjo]

If we all stick to challenging people's attitude, and remember they are challenging our attitude, then no need to get personal or abusive...

The attitude I'd like to challenge is:

  "It has not happened here / to me,
  therefore it might never happen,
  therefore I should carry on as normal (within the law),
  and NOT panic!"

IMO that is bound to speed the spread of the virus, compared to:

  "I'm not going to take any unnecessary risks, to my health or that of others."

At present those in UK have choices to make which is not the case on the continent. It could be that in another week those choices will have been decided by others, not by you!

[S2L]

Is all cycling carrying an 'unnecessary risk', with the impending clinical crisis then?

Commuting to work or to the shops is allowed in Italy... after all, not everybody drives and public transport is a good vehicle to spread the disease.
It's about being sensible

[MAC]

I only managed one calendar event in 2019, but I plan more this year and I am even offering some of my own events (although not until August onwards *Edit: perm versions available now!*). Unless there is an absolutely clear ban on such small events mine will be running. I will stagger starts, provide hand washing facilities and change controls if needed but life must go on and COVID-19 will spread despite this. Why not hunker down and try to avoid the contagion? I hear some cry. Because for most people it will just not be possible and nor is it desirable in the long term.

In the real world I work in Emergency Medicine and care for lots of poorly people, many of whom will test positive for COVID-19 over the next few weeks and months. I and my colleagues expect to contract the virus at some point, quite possibly but not certainly picked up from within the workplace. We are projecting a 5% staff infection rate at any one time if we all follow PPE guidance to the letter all the time (harder than you think). What we dread is staff illness over 25% as front line services will just not cope. We are trying to flatten the curve of infection rates and that is exactly the right approach for society as a whole.

I welcome contracting it this year when I am healthy, will likely make a good recovery and (hopefully) develop some future immunity. I fully subscribe to the concept of 'herd immunity' and definitely want to be part of that herd. I don't want to get ill at some distant future point when I am elderly or infirm and may well not survive. If enough people develop such immunity it is likely a) the virulence of the virus will diminish and b) the chance of spread to our current elderly and infirm will drastically lessen.

I have the utmost respect and understanding of decisions made to cancel some calendar events now. I am glad not to be in that position because the next few weeks are uncharted and uncertain and the decision may well be made for organisers anyway. I also understand why some riders may well decide to self isolate, even if well, in order to lessen the chance of becoming ill. For most of us though we will become part of the herd at some point. Realize this and plan accordingly, keep fit and enjoy your cycling.

[frankly frankie]

I'm no medic but I think assuming that catching this will confer immunity is a big assume.  If I believed that as an 'at-risk category' person my best strategy (a couple of weeks ago, now its too late) would have been to lay myself open to infection ASAP.

It’s easy to assume economics has driven this just because we don’t like the government etc, but we don’t actually know.

A few people have been unable to avoid making political points on this thread and I wish they wouldn't.  I know it's difficult because we are talking about 'government advice' but even so there's another place for scoring political points, not here.

Is there a "Coronavirus and not Audax" thread anywhere?

Yes there is and its growing exponentially and be warned it's not a comfortable read, especially the more recent pages.

This is a link to page 50 with postings on the 10th March.
https://yacf.co.uk/forum/index.php?topic=114653.1225

You have to 'opt in' using your personal settings on yacf to see this thread, because it has been deemed (by somebody) to fall under the 'political' sub-forum, a place where not everyone is nice all the time. 

[quixoticgeek]

Yes there is and its growing exponentially and be warned it's not a comfortable read, especially the more recent pages.

This is a link to page 50 with postings on the 10th March.
https://yacf.co.uk/forum/index.php?topic=114653.1225

You have to 'opt in' using your personal settings on yacf to see this thread, because it has been deemed (by somebody) to fall under the 'political' sub-forum, a place where not everyone is nice all the time.

Where is this setting? I can't find it anywhere obvious...

Edit: Scratch that, I found it.

J

[tonyh]

  beaten to it!

[andrewc]

I'm no medic but I think assuming that catching this will confer immunity is a big assume.  If I believed that as an 'at-risk category' person my best strategy (a couple of weeks ago, now its too late) would have been to lay myself open to infection ASAP.

It’s easy to assume economics has driven this just because we don’t like the government etc, but we don’t actually know.

A few people have been unable to avoid making political points on this thread and I wish they wouldn't.  I know it's difficult because we are talking about 'government advice' but even so there's another place for scoring political points, not here.

Is there a "Coronavirus and not Audax" thread anywhere?

Yes there is and its growing exponentially and be warned it's not a comfortable read, especially the more recent pages.

This is a link to page 50 with postings on the 10th March.
https://yacf.co.uk/forum/index.php?topic=114653.1225

You have to 'opt in' using your personal settings on yacf to see this thread, because it has been deemed (by somebody) to fall under the 'political' sub-forum, a place where not everyone is nice all the time.

I started the thread back in January.   The forum is Politics & _Other Big Issues._              That forum was made opt in because some people thought previous debate was a little strident.    Compared to recent posts in the Audax forum it's an oasis of calm...

[Hot Flatus]

That's audax for you 

[sojournermike]

It’s easy to assume economics has driven this just because we don’t like the government etc, but we don’t actually know.

A few people have been unable to avoid making political points on this thread and I wish they wouldn't.  I know it's difficult because we are talking about 'government advice' but even so there's another place for scoring political points, not here.

It wasn’t a political, more an anti-political point. I agree, this isn’t time for points scoring.

[sojournermike]

I’m an actuary, not an epidemiologist - although I nearly became one back in the day. We have similar and slightly overlapping skill sets.

I am being cautious. I have stopped riding my bike as I don’t want to be turned away from A&E if I have an off, but it turns out to be full. I expect that, all being well for me, I’ll start riding again towards the end of the year or into next year.

I understand the government strategy, although there is little detail of next steps apart from ‘leaks’ to Peston - a poor way of governing imho. I believe the strategy is a risky one and that, when this is past (could be a fairly long time) the impact and decision processes should be reviewed. We are stuck where we are.

There are a lot of factors here to think about, and only a few we can manage as individuals. What we can do is whatever we can to slow the spread and minimise the peak - that means limiting our social contact. The government policy to date hasn’t helped, because it makes working from home less easy than it might be for those that can and hasn’t set out how low paid workers will be supported. That may come.

One area that we don’t know is whether the modelling suggests that a very long spread would lead to more deaths overall as a consequence of the NHS being overwhelmed for 12-16 months rather than 3-4. It’s easy to assume economics has driven this just because we don’t like the government etc, but we don’t actually know.

 I am convinced that doctors will be presented with horrible choices to make about who gets treatment and that the aftermath will be one of shock for all those left. I think that will be a consequence of both the number of deaths that will touch the whole nation, and world, and the helplessness we face in dealing with numbers. That’s not anybody’s fault really and I will be the first to say that I wouldn’t want to be in the prime minister’s shoes at the moment.

Be kind to each other.

My understanding is the intention is to have a peak in 10 to 11 weeks time so that we are into the long tail before the next seasonal flu season starts. The peak has to be flat enough not to overwhelm nhs but not too flat for the isolation of vulnerable people to be too long (12 weeks is deemed acceptable). The timing of announcements will be designed to keep the rate just right, not too high and not too low.


Sent from my iPad using Tapatalk

Yes, exactly. But the numbers revealed to date aren’t pretty. CMO suggested 50% of infections in a 3-4 week period around the peak. If that is a two sided spread and the projection of 80% of population being infected that suggests an average of about 3.5m per week over that period. We don’t actually know how many of total infections will require ICU care, because the rates are measured against confirmed cases that may miss mild or asymptomatic infections. However, even if the measures are successful and that is the intent, that still looks like being a difficult period.

Of course, more measures may well be introduced and this may still prove the best course.

I could add more, but I would be straying further from my field and into conjecture.

Mike

[Davef]

I'm no medic but I think assuming that catching this will confer immunity is a big assume.

If you are infected by a virus and the infection lasts more than a few days (and you survive), then then adaptive immune system has kicked in. It will remember this response if you are infected even years later. This is also how vaccinations work, by injecting something that “looks like” the virus but does not make you ill the adaptive immune system is set up ready. The main problem is viruses mutate so the sars-cov-2 virus responsible for the COVID19 disease may change so that a future version is not recognised. This does not seem to be the case at the moment.

Herd immunity is another thing - if a sufficient percentage (50% 80% who knows) of the population becomes immune future outbreaks will not be able to get a foothold or spread so rapidly.


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[Hot Flatus]

@ mike

Of course economics is a factor! It has to be a factor, it's important. The internet is full of crap about Cummings using this as an opportunity to advance his eugenics ideology and Johnson secretly rubbing his hands at the possibility of the virus solving the social care crisis and the pensions deficit.

Truth is, food still needs to be delivered to supermarkets, utility companies still need to function, banks still need to operate or we are in deeper shit.

But anyway, the audax board is for endless squabbling  about arcane rules, points, and massive failures of financial management, not politics. 

[andrewc]

@ mike

Of course economics is a factor! It has to be a factor, it's important. The internet is full of crap about Cummings using this as an opportunity to advance his eugenics ideology and Johnson secretly rubbing his hands at the possibility of the virus solving the social care crisis and the pensions deficit.

Truth is, food still needs to be delivered to supermarkets, utility companies still need to function, banks still need to operate or we are in deeper shit.

But anyway, the audax board is for endless squabbling  about arcane rules, points, and massive failures of financial management, not politics. 

Oi!   We don't want the cycling equivalent of obsessive stamp collectors & trainspotters in our nice politics forum thankyouverymuch 

[sojournermike]

@HotF

Yep, I know economics is a consideration - not least because economic meltdown would kill lots more people. However, I was trying to avoid making political points in this arcane place;)

Meanwhile, and perhaps this belongs back the politics board, this chap has listed some interesting background to the research and planning

https://mobile.twitter.com/AdamJKucharski/status/1239209782894002177

[Davef]

I’m an actuary, not an epidemiologist - although I nearly became one back in the day. We have similar and slightly overlapping skill sets.

I am being cautious. I have stopped riding my bike as I don’t want to be turned away from A&E if I have an off, but it turns out to be full. I expect that, all being well for me, I’ll start riding again towards the end of the year or into next year.

I understand the government strategy, although there is little detail of next steps apart from ‘leaks’ to Peston - a poor way of governing imho. I believe the strategy is a risky one and that, when this is past (could be a fairly long time) the impact and decision processes should be reviewed. We are stuck where we are.

There are a lot of factors here to think about, and only a few we can manage as individuals. What we can do is whatever we can to slow the spread and minimise the peak - that means limiting our social contact. The government policy to date hasn’t helped, because it makes working from home less easy than it might be for those that can and hasn’t set out how low paid workers will be supported. That may come.

One area that we don’t know is whether the modelling suggests that a very long spread would lead to more deaths overall as a consequence of the NHS being overwhelmed for 12-16 months rather than 3-4. It’s easy to assume economics has driven this just because we don’t like the government etc, but we don’t actually know.

 I am convinced that doctors will be presented with horrible choices to make about who gets treatment and that the aftermath will be one of shock for all those left. I think that will be a consequence of both the number of deaths that will touch the whole nation, and world, and the helplessness we face in dealing with numbers. That’s not anybody’s fault really and I will be the first to say that I wouldn’t want to be in the prime minister’s shoes at the moment.

Be kind to each other.

My understanding is the intention is to have a peak in 10 to 11 weeks time so that we are into the long tail before the next seasonal flu season starts. The peak has to be flat enough not to overwhelm nhs but not too flat for the isolation of vulnerable people to be too long (12 weeks is deemed acceptable). The timing of announcements will be designed to keep the rate just right, not too high and not too low.


Sent from my iPad using Tapatalk

Yes, exactly. But the numbers revealed to date aren’t pretty. CMO suggested 50% of infections in a 3-4 week period around the peak. If that is a two sided spread and the projection of 80% of population being infected that suggests an average of about 3.5m per week over that period. We don’t actually know how many of total infections will require ICU care, because the rates are measured against confirmed cases that may miss mild or asymptomatic infections. However, even if the measures are successful and that is the intent, that still looks like being a difficult period.

Of course, more measures may well be introduced and this may still prove the best course.

I could add more, but I would be straying further from my field and into conjecture.

Mike

It is going to be grim.


Sent from my iPad using Tapatalk

[Hot Flatus]

@HotF

Yep, I know economics is a consideration - not least because economic meltdown would kill lots more people. However, I was trying to avoid making political points in this arcane place;)

Meanwhile, and perhaps this belongs back the politics board, this chap has listed some interesting background to the research and planning

https://mobile.twitter.com/AdamJKucharski/status/1239209782894002177

I know you know   
It was just a little vehicle to take the piss out of audax. God knows it needs it.

Yes, I've seen the link you've read and it is fascinating. I never assumed this strategy was thought up by politicians. I think their job is to deliver it, and communicate it.

Not very encouraged that they have waited until being at the foot of a tsunami to start talking about needing more ventilators. Easy to criticise, I know.

[FifeingEejit]

If anyone's concerned about emergency care not being available, A&E is not currently an access route for patients in severe or critical condition, the cases so far have gone to Infectious Diseases isolation units in certain hospitals (believe all Scottish cases requiring hospitalisation are currently in Edinburgh).

This will obviously change, as was noted in the local papers facebook feed by someone. the hospital that serves most of my area is currently being reconfigured so there is an isolation unit dedicated to cases for this virus (I was aware of this already but from wanderingpast hehheidyins at the right time).
The current structure plan for us at least appears to be to use dedicated services for this at the expense of routine services, the pressure on A&E will drop once we're forced to take the same route Spain is, particularly on Friday and Saturday nights which is plain carnage.

There's nothing currently mandating anyone to not ride their bike, so it's still personal choice just as it is any other day of the week in a country with a health service run close to the bone.

[MAC]

...the pressure on A&E will drop once we're forced to take the same route Spain is...

Anecdotally it has already dropped. Just half the number in my dept we would normally expect on a Sunday and it was similar yesterday. The calm before the storm??

[Hot Flatus]

People are too busy panic-buying and terror-scrolling to go out and have an accident

[MAC]

People are too busy panic-buying and terror-scrolling to go out and have an accident

most people don't attend ED with accidents!!

[hellymedic]

People are too busy panic-buying and terror-scrolling to go out and have an accident

most people don't attend ED with accidents!!

In my day, there was a palpable Sunday afternoon stream of sporting injuries, many minor.
Many sporting events have been curtailed and Minor Injury Units will now take some of these, but we had lots of 'quickies'. The numbers were large but the amount of time & attention needed were trivial.

[chrisbainbridge]

I think what MAC is saying is that whilst accidents on a Sunday are a recognisable stream they are a very tiny percentage of attendances. As 111 becomes risk averse, home visits stop and you get people see A&E as a first port of call the. Increasingly accidents become a smaller percentage.

We are going to take all relevant injuries direct from triage as from this week. This will be interesting as we are not set up for major blood loss management, ATLS screening, etc.

[bludger]

At this juncture it would make a great deal more sense to restrict unnecessary motor vehicle trips than anyone cycling since motorists hospitalise themselves and each other more than cyclists. It could be done via regulation of fuel sales.