Coronavirus - Overall
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Thought this was a pretty good article around the commentary from doctors both here and overseas:
My fellow doctors should zip it and let the experts fight this virus
*Do you have questions about COVID-19? Please, don’t ask your doctor. When it comes to coronavirus, most of us have no idea what we’re talking about.
I’m a general and infectious disease paediatrician in Sydney. I’m caring for kids hospitalised with suspected or proven COVID-19, so I want to call out some colleagues contributing to the confusion.
There are two types of doctors. Those who see patients (clinicians) and those who look after the population (public health doctors). Clinicians are the doctors to see if you have COVID-19; but the vast majority of us have never managed a pandemic in our lives. In fact, the first time most of us heard of "flattening the curve" was March 2020.*
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Do you have questions about COVID-19? Please, don’t ask your doctor. When it comes to coronavirus, most of us have no idea what we’re talking about.
I’m a general and infectious disease paediatrician in Sydney. I’m caring for kids hospitalised with suspected or proven COVID-19, so I want to call out some colleagues contributing to the confusion.
There are two types of doctors. Those who see patients (clinicians) and those who look after the population (public health doctors). Clinicians are the doctors to see if you have COVID-19; but the vast majority of us have never managed a pandemic in our lives. In fact, the first time most of us heard of "flattening the curve" was March 2020.
Some public health doctors, however, model and manage outbreaks for a living. Many have done so for decades. These women and men advise the body of chief medical officers chaired by Professor Brendan Murphy, the Australian Health Protection Principal Committee. Its recommendations are made public every time they meet and the national cabinet is bound by them.
Enormous credit is due to the AHPPC and Scott Morrison. At a time when the World Health Organisation felt it unnecessary, Australia was among the first countries in the world to impose travel restrictions on China. It cannot be overstated how brave this decision was: Murphy acted before most of his international counterparts and Morrison enacted the advice verbatim, despite the enormous economic impact. We are not Italy, but we might have been if not for this foresight.
Unfortunately, Morrison and Murphy’s education campaign has been woeful. They have created an information vacuum, and my colleagues scramble to fill it. King of the castle is journalist and physician Dr Normal Swan.
Swan claims he is holding decision-makers to account, but where tough questions need asking, he prescribes answers instead. This is particularly evident in his longstanding call for more testing. It’s a strawman argument, of course. Everybody would like to do more testing but there are not enough tests. So, the real-world question is: how to best use a small number of tests for a population of 23 million people? It’s hard to answer that – because it takes several specialised professionals to do so.
Another pet peeve are his back-of-the-envelope extrapolations of "the curve". It can feel as if we are perpetually at the point of no return. But of course, if interpreting an epidemic curve was a matter of simple arithmetic, expert advisers to the AHPPC, Professors Jodie McVernon and Vanessa Johnston, would be out of a job.
During their National Press Club address they explained what really matters: the rate of uncontrolled transmission of COVID-19 within Australia’s borders. This remains a small but growing proportion of total cases. They explain comparisons with other countries is confounded by testing regimens, demographics and many other variables. Interpretation takes supercomputers, not eyeballs.
Perhaps the most momentous push has been for an immediate national lockdown, including closing all schools. Swan is not alone on this. There are outbreak professionals breaking ranks, such as professors Raina MacIntyre and Brendan Crabb. Their objections are understandable. MacIntyre was a member of an external review panel advising the AHPPC; their majority recommendation of a lockdown was rejected.
But as the chair of that review, Dr Shitij Kapur, points out, there is more for the government to consider than numbers of COVID-19 cases. Morrison tactlessly pits this as lives against the economy, but the real concern is that prolonged isolation and a deep recession will kill people, too.
Make no mistake: the situation we face is dire. Many Australians will die from COVID-19 and many deaths will not be preventable. But the decision-makers can manage two big causes of preventable death.
First, hospital failure. If our hospitals fail, anybody needing help during that time could die. A mother with a difficult labour. A brother with an asthma attack. A daughter in a car accident.
But second, poorly timed and disproportionate public health measures will kill people, too. Consider this: the highest rate of male suicide ever recorded in Australia was during the Great Depression. Studies during the SARS outbreak demonstrate significant rates of mental illness years after people were in isolation.
Rampant suicide and mental illness. Might this be Australia’s fate if we get the macabre balance wrong? Who do you think is in the best position to navigate the way? Outbreak experts with all the data? Or twitter’s take on a graph? Perhaps it’s time we all zip it, and let the professionals do the talking.
Ben Smith is a general and infectious disease paediatrician in Sydney.
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That article doesn't make sense. Everyone knows Ben Smith is an accountant and not a friggen doctor!
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@Victor-Meldrew my bro signed up 4 days ago and is still waiting to have his ID verified. Keeps trying to sign into the app and keeps getting told to check his email for steps in verifying ID or some such...
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Parts of South Africa are going to get hammered
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@MiketheSnow It's a great concern that if it gets a hold in Africa where in many countries the infrastructure is not very robust, the outcome could be catastrophic.
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@Catogrande said in Coronavirus - Overall:
@MiketheSnow It's a great concern that if it gets a hold in Africa where in many countries the infrastructure is not very robust, the outcome could be catastrophic.
can almost guarantee that from what I saw when I was there - the continent is one big hot zone waiting to happen - zero to sweet fuck all infrastructure
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The USA is totally screwed.
Virus has entered the USA prison system. No protections in place for prisoners or guards. Mass release of remand and low level offenders into the community. Who knows how many are infected and gone home to their families untested? If a prison gets it, would be impossible to stop the spread to other prisoners and guards Another story I read talked about a guard who was sick for 2 days coughing and spluttering and carried on working before the prison eventually sent him home.
The USA is in serious trouble. Poor healthcare for people without super duper insurance, high levels of poverty and limited social welfare. Add to that, poor levels of trust in govt, a buffoon in charge and crippling levels of partisanship making a strong coordinated response impossible. Almost the worst possible combination of factors. They're also continuing to travel like mad and due to lack of social security, employees are continuing to work.
The USA death-rate is going to make Italy look like nothing. We could see 100,000 dead in a couple of weeks. It's going to be horrific.
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@Damo said in Coronavirus - Overall:
The USA is in serious trouble. Poor healthcare for people without super duper insurance, high levels of poverty and limited social welfare. Add to that, poor levels of trust in govt, a buffoon in charge and crippling levels of partisanship making a strong coordinated response impossible. Almost the worst possible combination of factors.
And a big dose of the general anti-science streak we are seeing emerge in a lot of countries.
This is scary:
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I just hope these scroats suddenly contract respiratory illnesses and Covid-19
The scientists working to steer Britain out of the coronavirus crisis are being targeted with death threats, the Telegraph can disclose.
Members of the public have sent threats to experts on the Scientific Advisory Group for Emergencies (SAGE), the publicly-funded organisation which advises the government at times of crisis.
A SAGE source said: “There are already all number of death threats being sent to people involved. In the last few weeks, some of the people who have been involved have received abuse in the street.”
It’s a combination [of people who are angry at the lockdown] and also this concept of herd immunity. A lot of people are under the misapprehension that all the scientists want people to die in order to protect the masses,” the source said.
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I don't want to get all full on journal here but its been an eventful weekend.
Work colleague sent home Thursday with symptoms is very poorly, her friend had been hospitalised Friday, died the same night, she was 70 so has 10 years on my colleague. Extremely sad to hear and my colleague lives alone, we are all keeping in touch with her but she's now feeling dreadful and grieving.
Two other colleagues have been poorly but manageable similar symptoms to eachother (sore throat dry cough and diarrhoea) , their husbands however are on about day 7 and feeling worse than ever, one of which works with a guy who is now in intensive care only 48.
Fourth colleauge is on day 2 of what we hope is recovery and now can talk without coughing and has the energy to get around the house. She's 62. (I work with a lot of older ladies)
A friend of ours is a male nurse at a local surgery, hes on day 7 too woke up feeling better, husband tells me he put on his Facebook he's feeling great then his wife updated it a few hrs back saying false alarm he's back downhill again.Thankful I worked those last two weeks at home and not been in any contact with above colleagues.
Really seems to be hitting men pretty bad apart from that one older lady who sadly died, also this pattern of feeling better then getting worse again hearing that a lot.Shits getting real now, definitely feeling more scared about it.
Stay safe guys.
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@R-L said in Coronavirus - Overall:
I don't want to get all full on journal here but its been an eventful weekend.
Work colleague sent home Thursday with symptoms is very poorly, her friend had been hospitalised Friday, died the same night, she was 70 so has 10 years on my colleague. Extremely sad to hear and my colleague lives alone, we are all keeping in touch with her but she's now feeling dreadful and grieving.
Two other colleagues have been poorly but manageable similar symptoms to eachother (sore throat dry cough and diarrhoea) , their husbands however are on about day 7 and feeling worse than ever, one of which works with a guy who is now in intensive care only 48.
Fourth colleauge is on day 2 of what we hope is recovery and now can talk without coughing and has the energy to get around the house. She's 62. (I work with a lot of older ladies)
A friend of ours is a male nurse at a local surgery, hes on day 7 too woke up feeling better, husband tells me he put on his Facebook he's feeling great then his wife updated it a few hrs back saying false alarm he's back downhill again.Thankful I worked those last two weeks at home and not been in any contact with above colleagues.
Really seems to be hitting men pretty bad apart from that one older lady who sadly died, also this pattern of feeling better then getting worse again hearing that a lot.Shits getting real now, definitely feeling more scared about it.
Stay safe guys.
🙏🏻😢Awful. Where do you reside?
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@pakman
UK West Midlands. Huge amount of cases piling up here, and tons you hear about word of mouth but won't know if they are actual covid19 cases or not as testing won't happen unless hospitalised.
The ones I know of that are poorly are all linked to Positive cases so more than likely.Edit. My work place might receive some of the new tests soon if they are rolling them out, will see if I can get some pics of process if I get tested for the geeks amongst you put not sure when as we are in general practice and no GP surgery is accepting patients at the moment. Just trying to maintain day to day practice with video and phone appts.