Bad beat/Moaning/Venting thread - Mammy told me not to come.

[Guest]

So we like to talk about covid 19 and the state reaction to it when it’s an expansion and reinforcement of whatever decisions are being taken at that moment in time? Good stuff. Argue weeks ago that further restrictions were not required, though they inevitably came. Laud high volume testing as our solution, and pivot to a severe restriction of testing that will essentially cut a huge swathe of population from receiving one as the correct and unquestionable policy.

So you can talk about the situation at length if you’re saying what we want to hear basically?

I argued further restrictions weren't required but the crux of comment is that these "further restrictions" you are applauding are actually far closer aligned to the measures in place yesterday than the Chinese restrictions you were advocating for.

Fair to say the restrictions you called for ie "full lockdown" never came and never will. Even the UK's "full lockdown" you applauded isn't remotely a full lockdown. Again highlighting the meaningless nature of that term.

The reason being of course is that notwithstanding us being a democracy, WHO are not advocating for such restrictions. We are taking a scientific approach not a social media driven approach.

Obviously, ambiguity can arise when people resort to all encompassing yet meaningless terminology but if you actually parse it out, it's clear to see these further restrictions are closer to a helpful reminder than impingement on people.

For example, I have now lost the ability to play golf at a course but little has changed for me bar the venue. I can still continue to walk for 4 hours around a grassy field swinging a golf club with up to 3 other people.

GAB already picked up on your "severe testing restriction" which is another example of sensationalist hyperbole.

[Guest]

Interesting to note that 'lockdown' may not be the silver bullet that social media suggests too. Primary schools still open in Sweden.

[Goodluck2me]

So we like to talk about covid 19 and the state reaction to it when it’s an expansion and reinforcement of whatever decisions are being taken at that moment in time? Good stuff. Argue weeks ago that further restrictions were not required, though they inevitably came. Laud high volume testing as our solution, and pivot to a severe restriction of testing that will essentially cut a huge swathe of population from receiving one as the correct and unquestionable policy.

So you can talk about the situation at length if you’re saying what we want to hear basically?

I think this seems to be a question of framing Lloyd.

You seem to be in the camp of test everyone whenever they ask for it so we can minimize all possible community transmissions to catch spreaders before symptoms.

Murdrum seems to see the changes as logical because we can only test so many, so therefore prioritizing (currently?) scarce resources for now to those with the most likely symptoms is reasonable.

I’m in the latter camp as there’s nothing to suggest that when we get to full capacity for tests we can always loosen the guidelines for testing again.

I think him should also be aware that people going into hospital currently are not being treated if they are “query Covid” until a negative test is produced meaning long delays for critically ill people. Prioritizing testing towards those in hospital for any reason I think is a necessary and logical step, until testing capacity increases.

[Mellor]

Testing everyone was leading to delays in people who may need urgent medical intervention getting a test because of capacity issues. Priority has now been introduced to fix that until more capacity can be delivered. What's the issue?

If some needs urgent medical attention then they need urgent medical attention. A test in that case is irrelevant It doesn’t matter if they have COVID, it matters that their lungs are failing. If the test comes back negative, they still need medical attention.
Testing is about identification, not treatment.

[Mellor]

Are some more... Pretty sure there's more as well

A had a few of those.
Was going on the assumption that each image is one song.
But there’s a few now that have been doubles of triple.

SPOILER

Albatross/Seagul
Brick in the a wall/Yellow Brick Road/Wonderwall

Us there any official “answer”

[ComradeCollie]

Can someone text this on thread . Want to send it on to some expats but they cant open it.

SPOILER

So it’s essentially come to this: President Trump is treating each of our 50 states as individual contestants on “The Apprentice” — pitting them against one another for scarce resources, daring them to duke it out — rather than mobilizing a unified national response to a pandemic.

If that’s the case, this is the episode where New York loses. The coronavirus is whipping through the state, especially New York City, at a terrifying rate. We need personnel, ventilators and personal protective equipment, stat.

But Trump’s response has been the same as President Gerald Ford’s in 1975, when our city, faltering on the brink of insolvency, begged Washington for help and was brutally rebuffed, a moment forever enshrined in The Daily News’s headline “FORD TO CITY: DROP DEAD.”

Now Trump is telling us the same. Literally.

Untold thousands will likely die absent federal intervention. And it needs to happen this instant — not just for the good of the city, but for the nation. The president needs to set a precedent in his hometown.

On Tuesday morning, Gov. Andrew Cuomo opened his daily coronavirus briefing on a far more somber note than usual, noting that the number of cases was climbing at a faster rate than even the experts had predicted, doubling roughly every three days. “The apex is higher than we thought and the apex is sooner than we thought,” he said. “That is a bad combination of facts.”
ImageMedical supplies are arriving at the Javits Convention Center in Manhattan, where a makeshift hospital is being constructed for coronavirus patients.
Medical supplies are arriving at the Javits Convention Center in Manhattan, where a makeshift hospital is being constructed for coronavirus patients.Credit...Demetrius Freeman for The New York Times

What it means, practically speaking: Our hospitals will soon be overwhelmed with Covid-19 patients. The governor has already said that the state is 30,000 ventilators short. The only way to acquire the volume we need — delivered at the speed we need — is through federal intervention, which means sending us the bulk of the ventilators from the strategic national stockpile, which has roughly 20,000, and deploying the Defense Production Act to force private manufacturers to make more.

But that’s not what the president is doing. He refuses to use the Defense Production Act, fearing it’ll put an undue burden on business, and he’s keeping his federal stash under tight lock and key. On Tuesday morning, Cuomo confirmed that FEMA would be sending the state only 400 ventilators. (“What are we going to do with 400 ventilators when we need 30,000?” he asked.) Vice President Mike Pence later said he’d send New York 4,000 from the stockpile — a fine start, but nowhere near what New York needs.

What is the president waiting for, and why is he hoarding — or let’s be charitable and say husbanding — his resources? Must the death toll in New York prove so calamitous he needs no further proof? Is he trying to make an example of his former home?
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“I will take personal responsibility for transporting the 20,000 ventilators anywhere in this country that they want, once we are past our apex,” Cuomo said. “But don’t leave them sitting in a stockpile, and say, ‘Well, we’re going to wait and see how we allocate them across the country.’ That’s not how this works.”

It would be one thing if other states were in the same dire position as New York. But they aren’t. We have 10 times the number of cases as Washington and eight times that of California. New Yorkers are now locked in place, waiting for the wave to come. As of Tuesday night, Dr. Deborah Birx, the coordinator for the White House Coronavirus Task Force, recommends that New Yorkers self-quarantine if they leave the state. Gov. Ron DeSantis of Florida is ordering anyone flying in from New York to self-quarantine for 14 days upon landing.

I guess Trump likes the numbers where they are. I have news for him: They won’t stay that way. The idea that New York is an exception rather than a harbinger is madness.

The rest of the country may regard New York as a black hole of need. But in fact the opposite has always been true; we’re forever sweeping more into the federal till than we receive in services. In 2018, according to the state comptroller’s office, we gave $26.6 billion more to Washington than we got back, ranking us dead last for federal benefits.

Now, we finally have a native New Yorker in the White House to do something about this discrepancy. Instead, he’s the worst offender, and this time the consequences will be lethal.

Part of me can’t help but wonder if Trump is just playing to his base, which views cities with suspicion, perhaps New York above all. We are multiculturalism personified — home of the United Nations, a place where 637 languages and dialects are spoken. A purée while the rest of the nation is vegetable soup, as Spalding Gray once lovingly said.

Never mind that Trump is himself a creature of New York, just a different dimension of New York. Tabloid New York, real estate New York and (above all, and most ironically) global New York, which made possible his worldwide hotels, his construction projects made of Chinese steel, his loans from Deutsche Bank. It’s a New York he now disavows. A New York he now blames.

But it was New York that made him a reality television star. And what reality television prizes more than anything, we’ve learned, is a Darwinian frame of mind. The contestants aren’t there to make friends. They’re there to destroy each other. They’re there to win. Only the best win.

But this is not a game. Trump has no clue how to marshal the forces of federal government, which he stripped down to the studs. He has no unifying instincts at all. New York will be gasping for breath, and the other states will soon follow. Unless he takes action, now.

[Hitchhiker's Guide To...]

...

[ComradeCollie]

Can someone text this on thread . Want to send it on to some expats but they cant open it.

SPOILER

White House officials expressed growing alarm on Tuesday about the coronavirus outbreak in New York City, advising people who have passed through or left the city to place themselves in a 14-day quarantine.

Officials warned that the outbreak could reach its peak in New York City much sooner than expected and said they had begun treating the region as a coronavirus hot zone, akin to areas of China and Europe overwhelmed by the virus.

About 60 percent of the new cases in the country were in the New York City metropolitan area, and the infection rate was eight to 10 times greater than other parts of the country, officials said at a briefing with the White House Coronavirus Task Force.

“Anyone in the New York metropolitan area who has traveled: Our task force is encouraging you to monitor your temperature, be sensitive to symptoms, and we are asking anyone who has traveled out of the New York City metropolitan area to anywhere else in the country to self-isolate for 14 days,” Vice President Mike Pence said.

“We have to deal with the New York City metropolitan area as a high-risk area,” he added.

Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, and Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said they were very concerned about people from New York City spreading the virus.

“We are starting to see new cases across Long Island that suggest people have left the city,” Dr. Birx said. “We can have a huge impact if we unite together.”

It was not clear if the White House had alerted Gov. Andrew M. Cuomo about the quarantine. “We’re talking to them about it,” President Trump said.

The White House warning came as Governor Cuomo offered a grim forecast for the outbreak in New York, saying that it would flood the state’s strained hospitals with as many as 140,000 stricken patients in the next few weeks.

Mr. Cuomo said that in New York City, new cases appeared to be doubling every three days. The crisis has already claimed the lives of more than 200 people statewide.

Despite the city’s growing efforts to slow the spread of the virus, Mr. Cuomo said the number of infections could reach its peak by mid-April, far outrunning earlier projections.

“We haven’t flattened the curve, and the curve is actually increasing,” Mr. Cuomo said. “The apex is higher than we thought, and the apex is sooner than we thought. That is a bad combination of facts.”
The Latest
Read our live coverage of the coronavirus outbreak in the New York area.

Confronting what he called these “astronomical numbers,” Mr. Cuomo, who has generally been restrained in his criticism of Mr. Trump during the crisis, lashed out for the first time at Washington’s response. He chastised the Trump administration for sending too few ventilators and drew an instant rebuke from the president.

The governor’s warnings came as millions of city residents sat hunkered in their homes and as all of its nonessential businesses — such as retail stores, barber shops and nail salons — were shuttered. One survey showed about a third of city residents had lost a job because of the epidemic or lived with someone who had.
ImageA woman in a medical mask put on plastic gloves as she entered a grocery story in Brooklyn on Tuesday.
A woman in a medical mask put on plastic gloves as she entered a grocery story in Brooklyn on Tuesday.Credit...Demetrius Freeman for The New York Times

Schools have been closed for more than a week and the typically crowded subways and buses were running at record-low capacities. Normally bustling streets were ghostly and empty.

As the number of cases in the city neared 16,000, the police launched a new series of patrols to encourage people to stay inside and to practice the appropriate “social distancing” that health experts recommend in order to stop the spread of the virus.
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In the expanding web of the outbreak, emotions ran high: More and more New Yorkers were starting to discover that their colleagues, friends and relatives were falling ill and some even dying. So far, 192 have died in the city.

“This crisis again, it’s not just numbers,” said Mayor Bill de Blasio. “It’s not just something happening somewhere else or to somebody else. This is something we all will feel very directly in our lives before it’s over.”

Speaking at the Jacob K. Javits Convention Center in Manhattan, a sprawling complex that the U.S. Army Corps of Engineers was scrambling to turn into a 1,000-bed hospital, Mr. Cuomo painted a bleak picture of the days and weeks ahead.

He projected that the state would soon require up to 140,000 hospital beds when only about 53,000 were now available for use. He also said that doctors could ultimately need as many as 30,000 ventilators when only a fraction of that number — somewhere around 5,000 — were currently available.
Image
On Tuesday, the governor visited the Javits Center in Manhattan, a sprawling convention complex that Army engineers were scrambling to turn into a 1,000-bed hospital.
On Tuesday, the governor visited the Javits Center in Manhattan, a sprawling convention complex that Army engineers were scrambling to turn into a 1,000-bed hospital.Credit...Stephanie Keith for The New York Times

On Monday, federal emergency officials announced that they were sending 400 ventilators to the state, a figure that Mr. Cuomo said barely dented what local officials desperately required.

“You want a pat on the back for sending 400 ventilators,” Mr. Cuomo said. “What are we going to do with 400 ventilators when we need 30,000 ventilators? You’re missing the magnitude of the problem.”

Not long after Mr. Cuomo spoke, Vice President Pence announced that an additional 4,000 ventilators were either on their way or would soon be sent to New York State.

The breathing machines were only one part of a landslide of medical equipment being rushed to hospitals in the city and its suburbs: 340,000 new N95 respirator masks; 145,000 new surgical gowns; and 350,000 new pairs of gloves.
THE LATEST Read our live global coverage of the coronavirus outbreak.

But even in such large amounts, the fresh supplies might not be enough to stave off disaster in the next two months, Mr. Cuomo said.

Sounding both alarmed and deeply frustrated, the governor said that he was baffled that the federal government had not done more. That prompted immediate criticism from Mr. Trump, who suggested that Mr. Cuomo had made choices years ago to forgo purchases that led to the shortages.

“I watch him on this show complaining,” Mr. Trump said of Mr. Cuomo. “He had 16,000 ventilators, he could have had a great price and he didn’t buy them.”

Steve Bellone, the county executive of Suffolk County, which covers eastern Long Island, said he knew of no evidence of the claim from the White House that a recent rise in cases in his jurisdiction stemmed from an outflow of city residents.

“We’ve had anecdotal reports of people coming from the city out to second homes on the East End and Fire Island,” he said. Were they spreading the virus? “I can’t say that — there’s no way to confirm whether anyone from the city spread the virus,” he said.

New York’s hospitals, struggling to treat the surge of new patients and keep their staffs from getting ill, dropped into a defensive crouch.

Two of the city’s biggest hospital networks, NewYork-Presbyterian Hospital and the Mount Sinai Health System, both implemented restrictive visitor policies that barred spouses, partners and other supporters from delivery rooms. The policy meant that mothers would now have to deliver their babies without help from friends, family or doulas.

“I have so much anxiety now and literally have not stopped crying after hearing that my husband can’t be with me,” said Samantha Moshen, 37, whose baby is due in early June.

Judy Sheridan-Gonzalez, an emergency room nurse at a hospital in the Bronx affiliated with Montefiore Medical Center, said that staff members at her facility, like many in the city, had been told to reuse their masks and other protective equipment.

On Sunday, she said, a shipment that Mr. Cuomo promised finally arrived, providing a reprieve for panicked workers.

“It was like Santa Claus came for Christmas,” said Ms. Sheridan-Gonzalez, the president of the New York State Nurses Association. “It was an unbelievable scene. It was like getting party favors. I never saw anything like it.”

In many ways, experts say, New York was fighting an uphill battle against the virus because of one of the city’s most distinctive qualities — its density.
Image
Fresh supplies being rushed to hospitals in the area might not be enough to stave off disaster in the next two months, Mr. Cuomo said.
Fresh supplies being rushed to hospitals in the area might not be enough to stave off disaster in the next two months, Mr. Cuomo said.Credit...Sarah Blesener for The New York Times

New York has many more residents per square mile than any other city in the country, and those crowded conditions appear to have allowed the virus to spread quickly through apartment buildings, subway cars and jam-packed parks. Federal officials say the city has an extremely high infection rate of one case for every 1,000 people.

Some city residents have chafed at the restrictions, continuing to play sports in parks and to allow their children to interact on playgrounds. At an afternoon news conference, Mr. de Blasio said that the authorities were giving city residents until Saturday to prove that they could safely stay away from each other.

“If it is not sufficiently clear,” he said, “that New Yorkers are following these rules, at that point, we will shut down playgrounds.”

Mr. de Blasio also said the city was seeking to immediately release about 300 inmates at Rikers Island who had been jailed for misdemeanors and other nonviolent offenses. Health officials have warned the epidemic could have disastrous consequences inside city jails.

Officials will also work to determine whether to release about 100 other people in the city’s jails who were awaiting trial, and about 700 more who were there on parole violations, the mayor said.

The mayor became emotional as he discussed the death in Florida on Tuesday of his friend, the Broadway playwright Terrence McNally, 81. Schools officials said that Dezann Romain, the 36-year-old principal of the Brooklyn Democracy Academy, had also died of the virus.

Though the New York area was the current epicenter of the outbreak in United States, Mr. Cuomo cautioned that it was also “the canary in the coal mine" for the rest of the country.

“What happens to New York is going to wind up happening to California and Washington State and Illinois — it’s just a matter of time,” he said. “We’re just getting there first.”

Michael Schwirtz, Joseph Goldstein and Christina Caron contributed reporting.

[Keane]

I often agree with Lloyd against the consensus here but he's just LOL on this.

We are ramping up our capacity to test at a rate of knots. We have been testing as many people as possible every day so far. We will continue to test as many people as possible every day in future.

The large and increasing volume of tests carried out will not be altered by prioritising those most likely to have the virus. They are not going to finish testing all the people with two symptoms and knock off for a half day while those with one symptom are left untested.

I'm actually frustrated by how stupid this argument is.

[Opr]

Interesting to note that 'lockdown' may not be the silver bullet that social media suggests too. Primary schools still open in Sweden.

How many days after lockdown though should we expect before seeing a divergence? I thought it was around 14 days? I presume that number is also calculated from countries with high social obedience while other countries probably should add a number of days.

Opr

[Guest]

Most recent study I saw put the median time to display symptoms at 5 days so you'd expect to see some effect by days 7-10 I'd have thought.

[ComradeCollie]

By the way a subscription to the (failing) New York Times is only €5 a month(for the first year, then €10), and can be payed for using phone credit via google pay.

[DeadParrot]

A had a few of those.
Was going on the assumption that each image is one song.
But there’s a few now that have been doubles of triple.

SPOILER

Albatross/Seagul
Brick in the a wall/Yellow Brick Road/Wonderwall

Us there any official “answer”

https://open.spotify.com/playlist/1Pf7HHD3x8dmIbgubJx5zP?si=2OE-mD3cS7CqE2qKpR6PPw

I still see others there (probably a licensing thing)
Road to hell/highway to hell etc

[Lao Lao]

I think that's 38. Not sure about the two with *'s. Slightly dubious.
Two I can see but I can't name are;

SPOILER

The house on the hill (top left)
The guy punching the cop. (Saturday night's alright for fighting is a bit weak.)
That'd be an even 40

I thought the guy punching the cop was

SPOILER

I predict a riot

[Solksjaer!]

Was gonna say I fought the law and the law won but it's not clear by that picture . Probably a draw .

[Opr]

Most recent study I saw put the median time to display symptoms at 5 days so you'd expect to see some effect by days 7-10 I'd have thought.

It definitely has to have a large effect and the time frame is just not right with so many factors involved. Holohan said yesterday that they had seen the number of contacts people were citing after contracting the virus drop from 20 to an average of 5 since the new measures were introduced. That alone would indicate a much lower R0 and a lower infection rate and a flattening of the curve unless it is so rampant in the general population that it makes little difference.

Opr

[Opr]

We are ramping up our capacity to test at a rate of knots. We have been testing as many people as possible every day so far. We will continue to test as many people as possible every day in the future.

All the focus from a media perspective that I have read has been on the number of tests we are doing. There are two parts to those tests. The taking of the sample and then the laboratory analysis. I am guessing the later is now going to be the bottleneck and they have probably realised that the increased capacity to take tests isn't going to be much good without increased capacity on the other side. I have seen loads of talk about all the new testing centres being built but very little around how much capacity can be ramped up on the other end. I'd imagine maybe that is much harder due to equipment, skilled people etc.

Opr

[Guest]

It definitely has to have a large effect and the time frame is just not right with so many factors involved. Holohan said yesterday that they had seen the number of contacts people were citing after contracting the virus drop from 20 to an average of 5 since the new measures were introduced. That alone would indicate a much lower R0 and a lower infection rate and a flattening of the curve unless it is so rampant in the general population that it makes little difference.

Opr

Yea maybe too soon to tell with delays in testing etc but I'll be keeping an eye on it as its the most comparable experiment in we have to go on so far I think.

[Denny Crane]

Interesting to note that 'lockdown' may not be the silver bullet that social media suggests too. Primary schools still open in Sweden.

Sweden has done about 1/3 of the tests Norway has done per capita, and has way higher deaths.

[Keane]

All the focus from a media perspective that I have read has been on the number of tests we are doing. There are two parts to those tests. The taking of the sample and then the laboratory analysis. I am guessing the later is now going to be the bottleneck and they have probably realised that the increased capacity to take tests isn't going to be much good without increased capacity on the other side. I have seen loads of talk about all the new testing centres being built but very little around how much capacity can be ramped up on the other end. I'd imagine maybe that is much harder due to equipment, skilled people etc.

Opr

I have no idea about that, but so long as we are maxing out our ability to test people every day we are not going to find less cases by testing people with two symptoms instead of testing people with only one.

[pokerhand]

SPOILER

Big Yellow Taxi
Streets Have no name
Clocks
Ring of ring
Great balls of fire
Bat of hell
Monkey Wrench
Waterfalls
Message in a bottle
Man in the Mirror
American pie
Cherry Bomb
THe Joker
Coffee and TV
Lovecats
Basset Hound*
Crocodile Rock
Ace of spades
Yellow submarine
Blue Suede shoes
Seagul
Sunrise
Smoke on the Water
Purple Rain
Man on the moon
Lucy in the Sky with Diamonds
Stairway to heaven
Champagne Supernova
Caged bird
Heartbeat
Candle in the wind
Yellow brick road
Running up that hill
Purple Hills
Helter Skelter
Fake Plastic Trees
Blackbird
Record player*

I think that's 38. Not sure about the two with *'s. Slightly dubious.
Two I can see but I can't name are;

SPOILER

The house on the hill (top left)
The guy punching the cop. (Saturday night's alright for fighting is a bit weak.)
That'd be an even 40

Don't follow music at all but did you miss

SPOILER

Knocking on heaven's door
Tears in heaven?

[Guest]

Sweden has done about 1/3 of the tests Norway has done per capita, and has way higher deaths.

More tests than Denmark though and Danes have more deaths.

[Kayroo]

I have no idea about that, but so long as we are maxing out our ability to test people every day we are not going to find less cases by testing people with two symptoms instead of testing people with only one.

Fewer.

Need my one a day.

[Guest]

Fewer.

Need my one a day.

Regular question on the GMAT. I expect you'd love the verbal section.

[Guest]

Bolsonsaro using the military to enforce the lockdown

SPOILER

to end

https://www.theguardian.com/world/video/2020/mar/25/bolsonaro-says-coronavirus-lockdowns-should-be-abandoned-video?CMP=share_btn_tw

[Hitchhiker's Guide To...]

...

[LuckyLloyd]

I think this seems to be a question of framing Lloyd.

You seem to be in the camp of test everyone whenever they ask for it so we can minimize all possible community transmissions to catch spreaders before symptoms.

Murdrum seems to see the changes as logical because we can only test so many, so therefore prioritizing (currently?) scarce resources for now to those with the most likely symptoms is reasonable.

I’m in the latter camp as there’s nothing to suggest that when we get to full capacity for tests we can always loosen the guidelines for testing again.

I think him should also be aware that people going into hospital currently are not being treated if they are “query Covid” until a negative test is produced meaning long delays for critically ill people. Prioritizing testing towards those in hospital for any reason I think is a necessary and logical step, until testing capacity increases.

That's not what I'm saying, though it would be ideal if we could have people test at home for this in the same way they can take their temperature. That would be a perfect scenario which we will obviously never reach.

I'm for GP's referring patients who are suspect cases following a clinical assessment over the phone or on Skype (what we were doing). I'm against only testing suspect cases that also fit into a limiting set of categories (what we're doing from today). That's it.

[Denny Crane]

More tests than Denmark though and Danes have more deaths.

more serious cases in Sweden. IDK, time will tell anyway.

[oleras]

I personally know of 2 people who had asked their GP to get tested, he obviously wasn't that strict because neither of them actually had symptoms, they didn't want to pass it on was their excuse. Stay inside and use social distancing then. Its like the writing of prescriptions for antibiotics, rather then explain that they will do feck all for a head cold, they just prescribe them, what a soul destroying job after all those years of training, basically a Tuesday job because they wanted office hours.

As for the reduced testing ?

Now, people with proper symptoms are getting priority testing and then, contact tracing can happen without having Mary clogging the system because she wants to visit her sister.

[Kayroo]

I'm for GP's referring patients who are suspect cases following a clinical assessment over the phone or on Skype (what we were doing). I'm against only testing suspect cases that also fit into a limiting set of categories (what we're doing from today). That's it.

If the public health specialists advice is to switch to a stricter testing criteria, what do you see as the good reason for maintaining the initial approach?

[LuckyLloyd]

I often agree with Lloyd against the consensus here but he's just LOL on this.

We are ramping up our capacity to test at a rate of knots. We have been testing as many people as possible every day so far. We will continue to test as many people as possible every day in future.

The large and increasing volume of tests carried out will not be altered by prioritising those most likely to have the virus. They are not going to finish testing all the people with two symptoms and knock off for a half day while those with one symptom are left untested.

I'm actually frustrated by how stupid this argument is.

You mustn't be, otherwise you would have posted a meme at me; lumped me with someone on mumsnet group (!?); or made out that this is about party politics (really?!). So you're faking it I reckon.

[oleras]

That's not what I'm saying, though it would be ideal if we could have people test at home for this in the same way they can take their temperature. That would be a perfect scenario which we will obviously never reach.

I'm for GP's referring patients who are suspect cases following a clinical assessment over the phone or on Skype (what we were doing). I'm against only testing suspect cases that also fit into a limiting set of categories (what we're doing from today). That's it.

I may be wrong, only just up, bloddy nights, but i was under the impression that just GP referrals were being tightened up, nothing about the number of tests being reduced, ie contact tracing ?

[Guest]

I'm for GP's referring patients who are suspect cases following a clinical assessment over the phone or on Skype (what we were doing). I'm against only testing suspect cases that also fit into a limiting set of categories (what we're doing from today). That's it.

Even if that approach allows us to catch the cases with the highest probability of the disease during a time where resources are finite?

Not to mention that these adjusted measures are in line with the WHO protocol. As the situation continues to evolve, those deemed "lower risk" will be seen.

Go to an ER, those sporting chest pains and head injuries get seen to prior to those with broken ankles. Greater risk to life supersedes who calls the doctor first.

[LuckyLloyd]

If the public health specialists advice is to switch to a stricter testing criteria, what do you see as the good reason for maintaining the initial approach?

The more epidemiological data the public health specialists have to hand in three weeks the better armed they will be to make some really tough decisions (as the decisions will become more difficult and the public querying of those decisions will become a lot louder). The more suspected cases we don't test and confirm the less they / we can be certain of. We also cut down on the amount of confirmed survivors confident they have had it and willing to re enter our economy and day to day life.

[ComradeCollie]

The WHO guidelines on testing is based off huge data and not the thoughts of Karen from Tallaght in a mumsnet group who's poor lil fella is not well at all, DM me hun.

Leave my niece out of this!

SPOILER

She's moved to Balbriggan anyway

[hotspur]

You mustn't be, otherwise you would have posted a meme at me; lumped me with someone on mumsnet group (!?); or made out that this is about party politics (really?!). So you're faking it I reckon.

Do you tend to change your mind much in the face of an overwhelming negative response to your view by obviously clear minded people? I'm asking genuinely.

[Kayroo]

The more epidemiological data the public health specialists have to hand in three weeks the better armed they will be to make some really tough decisions (as the decisions will become more difficult and the public querying of those decisions will become a lot louder). The more suspected cases we don't test and confirm the less they / we can be certain of. We also cut down on the amount of confirmed survivors confident they have had it and willing to re enter our economy and day to day life.

Sorry I don’t follow this logic. We are doing the same number of tests. We are just prioritizing who gets tested. So how do the public health doctors have less data in three weeks?

[LuckyLloyd]

I may be wrong, only just up, bloddy nights, but i was under the impression that just GP referrals were being tightened up, nothing about the number of tests being reduced, ie contact tracing ?

The tightening up is significant. Flow chart for GPs says you can only refer for test if you have a suspected case (this definition has been tightened):

A patient with acute respiratory illness (fever and at least one sign/symptom of respiratory disease, e.g., cough, shortness of breath);
OR
A patient with any acute respiratory illness AND having been in contact with a confirmed or probable COVID-19 case in the last 14 days prior to symptom onset;
OR
A patient with severe acute respiratory illness (fever and at least one sign/symptom of respiratory disease, e.g., cough, shortness of breath; AND requiring hospitalization) AND in the absence of an alternative diagnosis that fully explains the clinical presentation.

AND meets following criteria:

- symptomatic close contact of a suspect case
- symptomatic healthcare worker
- symptomatic at risk groups (diabetes, immonosuppressed, chronic lung disease, etc)
- symptomatic household contacts of at risk groups
- symptomatic staff / residents in long term care facility
- symptomatic prison staff / inmates where self isolation could not be facilitated
- symptomatic pregnant women (there's a note with that which indicates it isn't due to increased risk of complications)

If you're a suspected case with symptoms but don't meet the above criteria then no test referral.

These criteria would have been excellent upon which to base priority imo, but all of the suspected cases (particularly with tightened criteria for "suspect") should have been added to the backlog and got to eventually.

IF some suspect cases fell down the priority list to the extent their test came after 14 days and got false negatives as a result, so be it. There would be flak from the public for that, but I'd be okay saying the public were wrong to be annoyed about it.

Anyway, that's my take. Hopefully the world will return to normal and party politics will be worth discussing in a few months, and ye can shout at me about that instead.

[Kayroo]

Just to be clear Lloyd I’m not shouting at you. I’m honestly interested in a take that differs somewhat from mine.

If we can only do, say, 20,000 tests a week but in any given week we have 30,000 referrals, is it not sensible to improve the referral criteria further to ensure we have the highest chance of identifying actually infected patients? Also doesn’t it make sense to have a wide criteria during the initial stages of an epidemic that narrows as the contagion spreads?

[LuckyLloyd]

Just to be clear Lloyd I’m not shouting at you. I’m honestly interested in a take that differs somewhat from mine.

If we can only do, say, 20,000 tests a week but in any given week we have 30,000 referrals, is it not sensible to improve the referral criteria further to ensure we have the highest chance of identifying actually infected patients? Also doesn’t it make sense to have a wide criteria during the initial stages of an epidemic that narrows as the contagion spreads?

We can do 20k tests this week, but we might be able to do 50k tests in two weeks time. Refer on the basis of meeting strong criteria to need the test; prioritise the testing capacity within the referral bucket.

It may make sense to refine criteria for what a suspect case is based on outcomes and data, absolutely. But the tightening criteria knowingly and deliberately will deny test referral to patients GPs suspected have covid 19 under refined criteria for "suspected".

[Guest]

Sorry I don’t follow this logic. We are doing the same number of tests. We are just prioritizing who gets tested. So how do the public health doctors have less data in three weeks?

I kind of understand his logic from a data collection perspective but for me it doesn't compute for two primary reasons.

1. We're talking about potentially sacrificing human lives in order to gather a firmer grasp of the trends and clusters which exist among our population. This in turn may allow us to better combat the disease long term as we won't be dismissing the milder cases which may continue to spread among our population. There is some theoretical sense in there but not remotely enough to allow it to supersede the treatment of those most at risk.

2. The value of our data is somewhat limited. We live on a land mass that has very limited restrictions in terms of travel, identifying clusters is less relevant because it's free and easy movement.
Additionally, we're sparsely populated so isolating clusters is not as beneficial here because we're don't live in concentrated communities, high rise apartments etc. For example SK has a similar land mass to us but it has 10x the population so it has far more relevance in areas such as Seoul.

Also just to add, as the situation has continually shown, it's evolving so as the higher priority people are seen, priority testing will likely discontinue.

[pgodkin]

I think the one thing we can all agree on is that this is a complete balls!!!

Was out today... we do two shops in the week (cant really get around it due to freezer space) but what i seen was a ton of older people out and about children people running, cycling ok less cars but no less that a normal Wednesday during the summer time.

Down to local Tesco and they are restricting people entering the shop.. so crew of about 30 people waiting outside, to be fair they moved them in fairly quickly and i was in line for about 5 mins, but when i came out there was another load of about 40 people waiting to go in

Given previous experience I was looking at what people were buying and it was the same shit that they would buy the day after Stephen's day... it was just bit shopping... o we are here now might as well get something, not really needed

While i might be seeing only a small % I think we are in for a hard auld slog with this due to people not holding the line and staying indoors... if ever we needed a lash of bad weather it is now!!

[Guest]

Overall, it just seems so impractical/nonsensical to me.

The primary reason that jumps out to me is that you are effectively assuming that the methodology that GP's have been following in their assessments of patients to date contains the exact information that is required above.

If the information every GP has collected to date does not map on precisely to the above, would that not simply result in a skewed decision?

It just seems so logical to me to reassess cases under the precise new guidelines opposed to retrospectively mapping previous consultations to an adjusted methodology.

It feels analogous to asking someone to correct a Maths paper for the LC in 2020 based on exam question for 2019, you might have enough information to make a decision but it's unlikely it will all completely align.

[Strewelpeter]

We can do 20k tests this week, but we might be able to do 50k tests in two weeks time. Refer on the basis of meeting strong criteria to need the test; prioritise the testing capacity within the referral bucket.

It may make sense to refine criteria for what a suspect case is based on outcomes and data, absolutely. But the tightening criteria knowingly and deliberately will deny test referral to patients GPs suspected have covid 19 under refined criteria for "suspected".

When we can do 50K we'll do 50 k and they will refine the criteria to deliver the best outcome..

Yesterday the list was out of control where everyone with a sniffle or a cough on it. The HSE feel they need to target the limited resource and while I don't know if its the right call I'm sure it was a difficult call and they certainly aren't morons.


Of course we want to talk about it BBV would be out of business otherwise, the flowchart I posted was a joke and meant to be taken as such

So we like to talk about covid 19 and the state reaction to it when it’s an expansion and reinforcement of whatever decisions are being taken at that moment in time? Good stuff. Argue weeks ago that further restrictions were not required, though they inevitably came. Laud high volume testing as our solution, and pivot to a severe restriction of testing that will essentially cut a huge swathe of population from receiving one as the correct and unquestionable policy.

So you can talk about the situation at length if you’re saying what we want to hear basically?

What a load of nonsense.

Lots of people in here, yourself included, hold strong opinions on things they aren't experts in, and sometimes in things they know sfa about.

Murdrum, the only one here actually arguing with Lloyds actual viewpoint and its good reading tbh.

[AndyFatBastard]

The more epidemiological data the public health specialists have to hand in three weeks the better armed they will be to make some really tough decisions (as the decisions will become more difficult and the public querying of those decisions will become a lot louder). The more suspected cases we don't test and confirm the less they / we can be certain of. We also cut down on the amount of confirmed survivors confident they have had it and willing to re enter our economy and day to day life.

There's a blood test for recovery that checks for specific antibodies. That's a whole different thing. Anyone who believes they had it and are recovered will need both tests before they are given the all clear.

[Apache]

The more epidemiological data the public health specialists have to hand in three weeks the better armed they will be to make some really tough decisions (as the decisions will become more difficult and the public querying of those decisions will become a lot louder). The more suspected cases we don't test and confirm the less they / we can be certain of. We also cut down on the amount of confirmed survivors confident they have had it and willing to re enter our economy and day to day life.

Tony Holohan yesterday said that the previous ten days had led to:

far more (tests) than I think is either necessary as a result of the management of this disease or feasible or sustainable from our point of view in terms of testing and it was right and proper that we look at that and seek to focus the testing more on a smaller number of symptoms

But he's a moron and you know better, despite, as far as I'm aware, you having zero medical qualifications or pandemic experience. The absolute arrogance and self-confidence you display is astounding.

[Solksjaer!]

Jayz not reading the whole thread on this but is it not black and white what the symptoms are ? Bit of a bug myself this past week but no dry cough nor breathing difficulties. So zero alarm. Kids were coughing , zero alarm. The missus (risk factor) coughing , zero alarm. My point is our crazy GP would refer you for a test , however I'd be 100% sure it would be a waste .

As for being outside jogging . Where is the harm in that . I got soggy socks keeping my distance last sat in the park.

Our figures (in comparison) are good right ?

[eoghan104]

There's a blood test for recovery that checks for specific antibodies. That's a whole different thing. Anyone who believes they had it and are recovered will need both tests before they are given the all clear.

There is no test to show that you are now over the virus unless you are a medical health professional.

[AndyFatBastard]

There is no test to show that you are now over the virus unless you are a medical health professional.

This is fake news then? https://www.independent.co.uk/life-s...-a9423571.html

[Goodluck2me]

We can do 20k tests this week, but we might be able to do 50k tests in two weeks time. Refer on the basis of meeting strong criteria to need the test; prioritise the testing capacity within the referral bucket.

It may make sense to refine criteria for what a suspect case is based on outcomes and data, absolutely. But the tightening criteria knowingly and deliberately will deny test referral to patients GPs suspected have covid 19 under refined criteria for "suspected".

Then change the criteria in two weeks time. if we get to 50k capacity and we don’t do that amount due to these restrictions then I’m fully in your camp.

[Guest]

Then change the criteria in two weeks time. if we get to 50k capacity and we don’t do that amount due to these restrictions then I’m fully in your camp.

Precisely, obviously no one has once suggested that changes must exist into perpetuity. They're the 2nd time they've been adjusted already and they're in line with WHO.

If our capacity changes for good or for bad, adjust accordingly, this is very simple stuff.

[LuckyLloyd]

Then change the criteria in two weeks time. if we get to 50k capacity and we don’t do that amount due to these restrictions then I’m fully in your camp.

And what of the thousands of suspected cases not referred in between? And therefore not on the radar?

It is simple stuff! Keep them on the backlog!

[Fullof..It]

Do you tend to change your mind much in the face of an overwhelming negative response to your view by obviously clear minded people? I'm asking genuinely.

Very interested in reply. Whats the closest psychological disorder/bias to holding a position despite overwhelming logic on the opposite side?

[hotspur]

There is no test to show that you are now over the virus unless you are a medical health professional.

Since you will soon be a God among men, striding majestically through the pestilence with immunity, what are you going to do with your new superhero power?

Also we need to identify you to law enforcement so they don't accost you, and people don't recoil from you. So some kind of emblem should be affixed to your outer garments. A gold star perhaps.

On that note, what helpful or useful things have people been doing or are planning to do for others?

[hotspur]

Very interested in reply. Whats the closest psychological disorder/bias to holding a position despite overwhelming logic on the opposite side?

I have no wish to pathologise Llyod. But he seems to be ignoring me anyway.

[Fullof..It]

With the extra bit of time, decided to go back in time 20 odds years.

Loved this game at the time, downloaded it and it has aged terribly

Are there any games in similar genre (space fighter jets type) that are more recent?

[Strewelpeter]

There's a blood test for recovery that checks for specific antibodies. That's a whole different thing. Anyone who believes they had it and are recovered will need both tests before they are given the all clear.

Got a message today from my nephew whose phd was on antibodies and immune responses in cancer and has been switched from cancer to working on this virus for a few weeks.

...there is increasing talk about getting kits in (mainly to big corporations) to test if you have developed immunity to the virus, with the basic premise being that those who have developed immunity, can return to work/society etc. This kit tests for antibodies to the virus which are in some cases indicative of protection from infection (e.g. in flu). In the case of COVID19, there is absolutely no data showing protection via antibodies at this point. Hence if you do happen to get tested with one of these kits and have antibodies to COVID19, it does not mean you should return to society as you could catch it again and spread it. We will hopefully learn more on this front over the coming weeks.

[Fullof..It]

[The C Kid]

We're now on full housebound curfew from 15:00 to 06:00 every day. Any member of the public without the necessary papers that allow them to be out post curfew (healthcare, food delivery, utilities etc) gets a fine and 21 days imprisonment if caught. Initial curfew period is for 21 days and reviewed post that but i'd imagine a full lockdown will be in place before then. Army and police on the streets each afternoon.

All fairly surreal but seems to be uniformly well received from the local population so far.

[Lazare]

Proper lol at that