Generic Virus Thread

[KentVillan]

2 hours ago, snowychap said:

I think it's a leap to be saying that the decision is based upon other reasons as you did. Even if it were so, It doesn't necessarily follow that it will or does happen here.

My original comment was in relation to what happens if the UK runs out of capacity and has to start choosing who to treat. It was a hypothetical I was addressing, and using the most affected parts of Italy as the closest example. (FWIW, I think it probably will happen here, and lead to the ethical dilemmas I mentioned. You disagree, that’s fine.)

Edited March 11, 2020 by KentVillan

[Seat68]

56 minutes ago, rodders0223 said:

Corona doing wonders for the M6 and M5. Flew home from work last night, and into work this morning.

Would a cull be such a bad thing?

M42 due to 2 lanes closed was carnage. 

[snowychap]

13 minutes ago, KentVillan said:

You disagree, that’s fine.

I disagreed that it was part of 'triaging' or something that is part of a decision making process that medical professionals should (and even should be allowed to) make whatever the strain on resources - so whenever it may happen, i.e. now, tomorrow or in any hypothetical future.

I also largely disagree with your appraisal of the situation as it may be reported to be happening in Italy. I'd suggest that what you and I have read (i.e. those couple of twitter threads) is more likely to be down to a blanket clinical approach and a panicked, fraught, strained, haphazard, swiftly-implemented process rather than any conscious appraisal of some nebulous concept of importance to society.

You appear not to be getting what my issues with what you have written are (I'll fully accept that may be down to my lack of clarity) but I want to stress that it's not just whether it may happen or should happen but whether it actually is happening too (and thus how you get to your punt at what will occur).

[bannedfromHandV]

1 hour ago, rodders0223 said:

Corona doing wonders for the M6 and M5. Flew home from work last night, and into work this morning.

Would a cull be such a bad thing?

Have to say I’ve had similar thoughts.

 

If you take empathy and emotion out of this (two key elements of being human) then from a survival of the species perspective maybe this isn’t a bad thing. It’s targeting the old and infirm, with all due respect that’s the two most resource sapping elements of our society.

 

We all know we’re overpopulated, perhaps this is nature restoring some balance.

[Dante_Lockhart]

Ooooooooooooooo controversial.

Chinese scientists doing Mother Natures work.

[KentVillan]

21 minutes ago, snowychap said:

You appear not to be getting what my issues with what you have written are (I'll fully accept that may be down to my lack of clarity) but I want to stress that it's not just whether it may happen or should happen but whether it actually is happening too (and thus how you get to your punt at what will occur).

I get them - you think (reasonably) that triaging in Italy is continuing to happen on a purely clinical basis (regardless of how drastic the rules are), and that doctors wouldn't bring in value judgments about the individual patient. And that similar practices are / will be adhered to in the UK. You might be right.

My fear is that as you really saturate capacity, these ethical and social norms start to break down, and some of the stories coming out of Italy imply that is already happening. Certainly the questions will be posed, even if medical staff remain firm in their commitment to simply judging treatment priority on a clinical basis.

Here is a piece on whether the Italian age approach would fly in the US: https://news.yahoo.com/faced-tough-choices-italy-prioritizing-194901319.html

Quote

In Italy, where more than 9,000 people have been diagnosed with COVID-19, doctors are scrambling to secure resources and treat patients. They have been forced to prioritize the young and otherwise healthy.

"It's very hard to just prioritize the young over the old. That would not fly in the US," Arthur Caplan, the head of the division of medical ethics at NYU School of Medicine in New York City, told Business Insider. "People would protest the idea that young lives are worth more inherently than older lives." 

...

Those conversations, which will likely vary by hospital and region, should touch on not just the age of the patients but also their health and a number of other factors, Caplan said. 

"If you had, let's say, an ICU that was overwhelmed, you're probably going to try and give some extra attention to healthcare workers because you need them to deliver care," he said. "The rationale isn't that they're more worthy; it's that they can contribute in the longer run to saving more lives."

Do you see what I'm driving at? It becomes a value judgment, rather than a clinical judgment? That last quote is exactly about "importance to society".

Edited March 11, 2020 by KentVillan

[Nigel]

I can not believe that they let Cheltenham go ahead!

 

[tonyh29]

related to the post  2 above  but I spoke to someone in Italy yesterday , essentially they were saying their health system can't cope and the preference is  to kind of prioritise on those they believe can be saved  ,

 

of course , this is from a sample size of one , so requires the usual caveat

Edited March 11, 2020 by tonyh29

[Stevo985]

4 minutes ago, Nigel said:

I can not believe that they let Cheltenham go ahead!

 

Me neither. And I'm going!

[KentVillan]

 

[tonyh29]

36 minutes ago, bannedfromHandV said:

Have to say I’ve had similar thoughts.

 

If you take empathy and emotion out of this (two key elements of being human) then from a survival of the species perspective maybe this isn’t a bad thing. It’s targeting the old and infirm, with all due respect that’s the two most resource sapping elements of our society.

 

We all know we’re overpopulated, perhaps this is nature restoring some balance.

I kinda agree  , which is easy from the position of someone who is low risk  ... the lockdowns could potentially be the start of people buying shotguns  , stockpiling and barricading their houses  ..or you go about life as usual and accept that a few thousand will die until a cure is found

Harsh , indeed and I really  don't wish to appear unsympathetic or callous  , but to a degree it's the only logical way to carry on

[snowychap]

1 hour ago, KentVillan said:

I get them

I still don't think that you do, I'm afraid.

1 hour ago, KentVillan said:

you think (reasonably) that triaging in Italy is continuing to happen on a purely clinical basis (regardless of how drastic the rules are), and that doctors wouldn't bring in value judgments about the individual patient

No, that is not a correct reading of what I think.

I am questioning the validity of the inferences you seem to be drawing from the anecdotal reports and the ensuing application of those inferences in predicting what may, will, should or will have to happen in a future hypothetical situation in the UK.

I am also saying that any such approach (of extending triaging beyond an assessment of the best allocation of resources for clinical purposes) does not really constitute triaging.

1 hour ago, KentVillan said:

My fear is that as you really saturate capacity, these ethical and social norms start to break down, and some of the stories coming out of Italy imply that is already happening. Certainly the questions will be posed, even if medical staff remain firm in their commitment to simply judging treatment priority on a clinical basis.

Of course stresses upon resources (and other things) cause ethical and social norms to come under strain and 'questions to be posed' - that's really taken as a given, isn't it? What we are talking about isn't just about norms, though.

They are about the essential ethics of a profession. The robustness of principles is how they deal with stresses and strains. If they get discarded under stress then they were of no value at any other time.

1 hour ago, KentVillan said:

Here is a piece on whether the Italian age approach would fly in the US

Again, I don't particularly agree with your reading of this.

It would appear to draw the same inference that you have (which I still question) that the age question is about 'young lives' being worth more than 'older lives' so that part just appears a repetition of what you posted with which I have already taken issue.

The bit about the extra attention to healthcare workerss is, in essence, a clinical decision as it affects the potential overall clinical outcome for existing and future patients. I still would very much question any decision-making on that basis and certainly would say that it would be a very dodgy thing to put that kind of decision-making in the hands of clinicians.

1 hour ago, KentVillan said:

Do you see what I'm driving at? It becomes a value judgment, rather than a clinical judgment?

Discussions about these things - a wider discussion of medical ethics, whether decisions can be made on the basis of wider criteria than clinical considerations, who should be making them, on what basis should they be made and so on are fine to be having (at any time but especially more so now) but this is not the basis for the disagreement we had and still appear to have.

Again, round in circles.

 

Edited March 11, 2020 by snowychap

[KentVillan]

Edit: Overreaction, never mind.

Edited March 11, 2020 by KentVillan

[tonyh29]

11 minutes ago, KentVillan said:

Not for the first time, not arguing in good faith, and being unnecessarily rude, so I’m out. Pick on someone else.

tbf although you may not agree with each other ,  I don't see anything rude in his post  , if anything he seems to have gone out of his way not to be rude

 

[snowychap]

Edited in line with edit above.

Edited March 11, 2020 by snowychap

[wazzap24]

Play nice lads FFS, it’s the end of days. 

[rodders0223]

1 minute ago, wazzap24 said:

Play nice lads FFS, it’s the end of days. 

Worst end of days ever. I was promised looting, pillaging and destruction. Not lads getting snippy on a message board.

[wazzap24]

Home Brew 

Spit or swallow? 

Edit: looks more spunky in the flesh. 

Edited March 11, 2020 by wazzap24

[ml1dch]

So....now what are we supposed to do?

 

 

[Tayls]

4 minutes ago, ml1dch said:

So....now what are we supposed to do?

 

 

Why cant people just learn to use Skype instead of people flying around from XYZ or travelling for hours in a car or other forms of public transport. 

Edited March 11, 2020 by Tayls