Generic Virus Thread

[bannedfromHandV]

1 hour ago, Genie said:

The Prime Minister seems to think it is relevant enough to publicly tell off Starmer for his comments

I think Starmer should have picked something better to try and push BJ in front of the bus with. This was a botched assassination attempted. I think he should have not bothered with what was written on the website 3 months ago and managed that particular complaint differently. Now his card is marked. 

Now his card is marked?

He’s the leader of the opposition, something tells me his card may have been marked already.

[PaulC]

I think I prefer BJ to Cameron. He’s said that austerity is not going to happen after all this is over 

[StefanAVFC]

Just now, PaulC said:

I think I prefer BJ to Cameron. He’s said that austerity is not going to happen after all this is over 

Well, that's that then.

[ml1dch]

1 minute ago, PaulC said:

I think I prefer BJ to Cameron. He’s said that austerity is not going to happen after all this is over 

The bold bit is the problem. 

[Seat68]

He will die in a ditch before austerity happens. 

[PaulC]

1 minute ago, StefanAVFC said:

Well, that's that then.

You don’t believe it then 

[Davkaus]

 

2 minutes ago, PaulC said:

You don’t believe it then 

There are people that don't believe Boris, then there are gullible fools.

Fool me 99 times, shame on you...

[PaulC]

Just now, ml1dch said:

The bold bit is the problem. 

Ok according to Vine there’s three options

1. Raise taxes 

2 austerity 

3 ride it out like the Atlee govt did 

[bannedfromHandV]

10 minutes ago, PaulC said:

I think I prefer BJ to Cameron. He’s said that austerity is not going to happen after all this is over 

Fantastic, i can’t think of a single time untruths have spilled from that fat aristocratic scumbags lips.

[VILLAMARV]

18 minutes ago, Genie said:

Can we agree that it isn't actually policy that once you get above an arbitrary unconfirmed age you're considered a lost cause by the NHS and left to not only die, but kill those around you?

I genuinely don't know. And that's not to be obtuse or obstructive but, as ever, it's complicated. I don't believe you will find anything like that written on a government website if that's what you mean, but that doesn't necessarily mean it's not part of any triage guidance for clinicians. If that means you can 'win' a semantic argument on the internet with someone, go ahead and claim your internet points if it serves a purpose, but individual clinicians at individual trusts may well have different guidance. Don't forget the conversation moved some time ago to one of protecting finite resources and away from care at the point of need. (Helped in no small part by the Lansley reforms but a discussion perhaps for a different time). Define 'policy'. Government advice provides a part of the framework.

What should be absolutely obvious to everyone is that people, primarily the elderly, but also those with underlying health conditions, those that ambulances didn't collect (for a myriad of reasons), those who decided to not bother the nhs and stay at home, as well as those that filled out forms to say don't waste time and resource on me. Have all died. Without receiving care at the point of need. And they've done so in their thousands. Somewhere along the line triage decisions have been made in some of those cases and they will have been made, in line with guidance led policy decisions be that at government level, trust level, hospital level etc.

What should also be obvious is that residents of care homes have indeed been left to fend for themselves en masse. It's borne out in the statistics as well as in individual accounts.

How this all started of course, both the national situation and indeed this conversation, was off the back of the government advice that was, freeing up capacity as @LondonLax said, and as I very much agreed with.

18 minutes ago, Genie said:

 Its pretty obvious that it isn't and by the silence nobody is going to admit that its a conspiracy theory.

That's a strange logical conclusion to my mind.

[hogso]

Murmurings of a public sector pay freeze from the unions this morning. Big shocker, not. They wouldn't dare touch NHS workers for fear of reprisals from voters I would have thought, and maybe excluding the Police Force, as far as the rest of us goes, no one really gives a shit.

[Stevo985]

2 hours ago, Genie said:

The Prime Minister seems to think it is relevant enough to publicly tell off Starmer for his comments

The Prime Minister is saying the context of the advice Starmer is referring to was the part you quoted. But it wasn't, the part Starmer was referring to was a different part of the document. Might be an error on Johnson's part, might not.

2 hours ago, Genie said:

I think Starmer should have picked something better to try and push BJ in front of the bus with. This was a botched assassination attempted. I think he should have not bothered with what was written on the website 3 months ago and managed that particular complaint differently. Now his card is marked. 

But his point isn't what was written on a website 3 months ago. His point is that Johnson is lying about it NOW. That's his issue. That when questioned about government advice, Johnson is lying about it now in the present day.
He's not written to the prime minister to ask him to correct a website from 3 months ago. He's writing to ask him to correct what he said in parliament this week which was a lie.

You keep trivialising this by passing it off as a bit of wording on a website 3 months ago. The entire point is that the PM is currently lying about it. In parliament.

I don't agree with the bit in bold at all. I think you're making far more of what Starmer did than what it was, and far less of what Johnson did. I'm not sure why.

Edited May 14, 2020 by Stevo985

[Stevo985]

47 minutes ago, PaulC said:

I think I prefer BJ to Cameron. He’s said that austerity is not going to happen after all this is over 

Well he's never lied before

[HanoiVillan]

32 minutes ago, Genie said:

Ok, so people say "its policy", I say "where is this policy?", you says its irrelevant. Got it.

I think the issue is that you are demanding people produce a document titled 'This Is The Smoking Gun'; I don't know whether that exists. It is possible to observe what is actually happening in the country, though, and it hasn't gone unreported. For instance, many care home residents have been given letters to sign saying they don't want to be treated in hospital:

Care home residents claim they are being asked to sign letters agreeing they WON'T go to hospital if they get coronavirus - after Health Secretary Matt Hancock pledged to ban blanket use of 'do not resuscitate' plans

'Care home residents say they are being asked to sign letters agreeing to not be taken to hospital if they become ill the coronavirus.

Elderly people are being asked to sign the agreements en masse as hospitals come under intense pressure from thousands of patients with the infectious disease.

[...]

One woman living in a care home in Wiltshire, Elizabeth Diacon, 97, said she and 'several friends' were asked to sign the letters but claims she did not feel pressured.

Ms Diacon, who worked in military intelligence at the Bletchley Park codebreaking operation in Milton Keynes in World War Two, said: 'I'm not afraid of dying but I'm rather afraid of how I might die. I'd rather do it here than go to hospital.' 

It comes as there are fears elderly patients won't get life-saving care despite the Government banning the use of blanket Do Not Resuscitate (DNR) orders for groups of people.

[...]

Speaking on BBC Radio 4's Today programme this morning, Ms Diacon said 'all who could' at her care home had been asked to sign the letter.

'To say that if we fell ill that we would not go to hospital,' she said. 'Unless of course we broke a hip or something.'

Ms Diacon said she 'presumed' the form was referring to the event in which they became critically ill with the coronavirus, which causes pneumonia. 

She added: 'I don't know where the form came from but I've spoken to several friends in care homes and they've all had to sign it.'

Asked whether she felt she had been pressured into signing the form Ms Diacon told the BBC: 'You didn't have to - you were asked if you would sign it, to agree.

'And I thought I would rather be ill here than go to hospital. Our local hospital is much overworked and it has the virus there.

'I'm not afraid of dying but i'm rather afraid of how I might die. I'd rather do it here than go to hospital.' 

When questioned about the letter, Health Secretary Matt Hancock said they were 'standard procedure' and that it was appropriate as long as people aren't pressured.

He claimed that residents often say they would rather die in the home than a hospital ward, adding: 'It is reasonable and right, I'd argue a good thing, to ask people their wishes.'

The form is not the same as a Do Not Resuscitate (DNR) order, which dictates that someone should not be given CPR if they die.

It would, however, mean someone wouldn't get the lifesaving medical care available in a hospital and be limited to what care home staff and on-site doctors can provide.'

(from: https://www.dailymail.co.uk/news/article-8226675/Care-home-residents-asked-sign-letters-agreeing-WONT-hospital-COVID-19.html)

Mrs Diacon says she wasn't pressured into signing the form, and I've no reason to believe she's lying, but it's clearly true that she wouldn't be signing this form if coronavirus weren't happening. GP surgeries have also been communicating to care home residents in some areas to tell them they shouldn't be admitted to hospital, and will be denied access to a ventilator if they go there:

Exclusive: Care home residents told they are 'unlikely' to be offered ventilators

'ITV News has been passed a letter sent by GP surgeries to dozens of care homes warning that residents are unlikely to be put on a ventilator if they are admitted to hospital with Covid-19.

The letter, sent by a chain of GP surgeries across the East of England, states that anyone "frail enough to require full-time care" is "unlikely to benefit from mechanical ventilation" and therefore is unlikely to be offered the treatment in hospital.

The letter also says that GPs recommend patients are treated in their care homes, "including good end of life care if it becomes clear they are not going to survive the infection."

The two page letter was sent to thousands of residents, including to one care home which looks after adults with learning disabilities.'

(from: https://www.itv.com/news/2020-04-20/exclusive-care-home-residents-told-they-are-unlikely-to-be-offered-ventilators/)

Some care homes have produced documents suggesting that their residents are unlikely to be admitted to hospital as a result of the triage process:

Leaked documents reveal coronavirus patients to be treated in care home in plan branded 'madness'

'Leaked documents reveal that at least one nursing home in Scotland will take in non-residential new patients as well as returning ones.

[...]

Staff at Newcarron Court care home in Falkirk were told it had introduced an emergency contingency plan in response to uncontrolled admissions of individuals “highly likely” to be carrying the killer illness.

The home’s owner, Advinia Health Care, has confirmed the Falkirk facility, one of 11 they run across the country, was helping local hospitals with “capacity issues” by taking in non-residential patients and returning ones.

[...]

Staff were also told “acutely unwell” residents would “probably not be admitted to hospital” and that relatives were only to be informed of this “if required”.'

The document:

(from: https://www.dailyrecord.co.uk/news/scottish-news/leaked-documents-reveal-coronavirus-patients-21889848)

It's not hard to see what is actually happening out there if you look for it.

 

[Dodgyknees]

There will be austerity and the hardest hit will be most of us on this forum.

[PaulC]

17 minutes ago, hogso said:

Murmurings of a public sector pay freeze from the unions this morning. Big shocker, not. They wouldn't dare touch NHS workers for fear of reprisals from voters I would have thought, and maybe excluding the Police Force, as far as the rest of us goes, no one really gives a shit.

That’s what I heard too but surely they would make an exception for the  Nhs. Police and civil servants fine 

[Genie]

Thanks for your informative post @HanoiVillan lots of interesting information. I think there is still a gap between “UK has a policy not to treat old people” which was claimed several times and what is actually happening (which is far from good). I know for a fact some old people are being treated and tested. It seems like at more local levels the most frail in the community are being managed differently for several reasons.

[bickster]

17 minutes ago, VILLAMARV said:

but that doesn't necessarily mean it's not part of any triage guidance for clinicians.

I linked the NICE Triage algo up thread but apparently that has nothing to do with government advice (there isn't a big enough rolly eyes thingy to post here). What it doesn't explicitly say is how much age is a factor in the Frailty Score, I believe but haven't got around to finding it yet, that age is 50% of the score, effectively meaning anyone over 65 doesn't get admitted. I'm also aware that this triage doesn't tend to get done in hospital but prior, possibly by the paramedic / doctor that gets the initial response call

[Seat68]

I am all set. 

[VILLAMARV]

9 minutes ago, bickster said:

I linked the NICE Triage algo up thread but apparently that has nothing to do with government advice (there isn't a big enough rolly eyes thingy to post here). What it doesn't explicitly say is how much age is a factor in the Frailty Score, I believe but haven't got around to finding it yet, that age is 50% of the score, effectively meaning anyone over 65 doesn't get admitted. I'm also aware that this triage doesn't tend to get done in hospital but prior, possibly by the paramedic / doctor that gets the initial response call

Patient care pathways are boring though.

It all adds up to contribute to the decisions, which all ultimately mean nothing at all if there is no room at the inn. 

The point (in reality) around the advice discussed yesterday is surely that once the room had been made in the system to accommodate higher numbers of admissions that the advice was withdrawn or changed and that's the thing getting lost I feel while everyone riffs off people's individual previous posts. (Including me).