The thing is, the UK public actually responded very well to voluntary isolation.
, most Britons followed the rules. The outrage over Dominic itself is proof that Britons aren't going to allow elites to sidestep minor barriers, even if it's "legal".
Moderators: Alyrium Denryle, Edi, K. A. Pital
The thing is, the UK public actually responded very well to voluntary isolation.
Not quite:
It’s not necessary to consider blanket do-not-resuscitate orders for SARS-CoV-2 (COVID-19) patients because there’s insufficient data on US survival rates and for in-hospital resuscitation, according to a new article published today in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.
Although there is a presumption that COVID-19 patients have a low survival rate following resuscitation, that presumption comes from a recent study from Wuhan, China, that found an overall survival rate of 2.9% in almost 140 SARS-CoV-2 patients who underwent cardiopulmonary resuscitation for in-hospital cardiac arrest.
However, that prognosis should not be applied to the U.S., said Saket Girotra, M.D., S.M., assistant professor of medicine in the division of cardiovascular diseases at the University of Iowa Carver College of Medicine, on behalf of the American Heart Association’s Get With The Guidelines®-Resuscitation (GWTG-R) investigators in a press release.
In this study, the researchers evaluated data from 2014-2018 on 5,690 patients similar to the COVID-19 population. The patients of interest underwent CPR for in-hospital cardiac arrest while being treated in an intensive care unit (ICU) for pneumonia or sepsis and were receiving mechanical ventilation at the time of cardiac arrest.
While researchers noted an overall survival rate of only 12.5% in the U.S. simulation, there were many variables that could affect survival and neurologic outcomes. The probability of survival without severe neurological disability ranged from less than 3% to more than 22%, across key patient subgroups. The probability of mild to no disability ranged from about 1% to 17% across key patient subgroups.
Researchers observed that survival rates were low in older and sicker patients with non-shockable heart rhythms, and survival rates were much higher (more than 20%) in younger patients with an initial shockable rhythm who were not being treated with vasopressor medications prior to the cardiac arrest. Moreover, vasopressor medications are generally used to improve blood pressure and cardiac output in emergency situations such as septic shock or cardiac arrest.
“Such large variation in survival rates suggests that a blanket prescription of do-not-resuscitate orders in patients with COVID-19 may be unwarranted. Such a blanket policy also ignores the fact that early experience of the pandemic in the U.S. reveals that a about a quarter of COVID-19 patients are younger than 50 years of age and otherwise healthy. Cardiac arrest in such patients will likely have a different prognosis,” the researchers said, according to the release.
No evidence blanket 'do-not-resuscitate' orders for COVID-19 patients are necessary @HeartNews https://t.co/c52uChvBRh
— Medical Xpress (@physorg_health) May 22, 2020
The authors wrote in conclusion that “… in a cohort of critically ill patients on mechanical ventilation, survival outcomes following in-hospital resuscitation were not uniformly poor. These data may help guide discussions between patients, providers and hospital leaders in discussing appropriate use of resuscitation for COVID-19 patients.”
No evidence blanket ‘do-not-resuscitate’ orders for COVID-19 patients are necessary. https://t.co/I5c3wJx6DA
— AHA Charlotte (@HeartofCLT) May 22, 2020
To be honest, I'd expect bullshit from the personal doctor of Silvio Berlusconi. In any case, it doesn't seem to have any backing, unfortunately. Though I'm sure its only a matter of time before Trump and his ilk seize on this "alternative fact", if they haven't already.World Health Organization experts and a range of other scientists said on Monday there was no evidence to support an assertion by a high-profile Italian doctor that the coronavirus causing the COVID-19 pandemic has been losing potency.
Professor Alberto Zangrillo, head of intensive care at Italy’s San Raffaele Hospital in Lombardy, which bore the brunt of Italy’s epidemic, on Sunday told state television that the new coronavirus “clinically no longer exists.”
But WHO epidemiologist Maria Van Kerkhove and several other experts on viruses and infectious diseases, said Zangrillo’s comments were not supported by scientific evidence.
There is no data to show the new coronavirus is changing significantly, either in its form of transmission or in the severity of the disease it causes, they said.
“In terms of transmissibility, that has not changed, in terms of severity, that has not changed,” Van Kerkhove told reporters.
It is not unusual for viruses to mutate and adapt as they spread. The pandemic has so far killed more than 370,000 people and infected more than 6 million.
Martin Hibberd, a professor of emerging infectious disease at the London School of Hygiene & Tropical Medicine, said major studies looking at genetic changes in the SARS-CoV-2 virus that causes COVID-19 did not support the idea that it was becoming less potent, or weakening in any way.
“With data from more than 35,000 whole virus genomes, there is currently no evidence that there is any significant difference relating to severity,” he said in an emailed comment.
Zangrillo, well known in Italy as the personal doctor of former Prime Minister Silvio Berlusconi, said his comments were backed up by a study conducted by a fellow scientist, Massimo Clementi, which Zangrillo said would be published next week.
Zangrillo told Reuters: “We have never said that the virus has changed, we said that the interaction between the virus and the host has definitely changed.”
He said this could be due either to different characteristics of the virus, which he said they had not yet identified, or different characteristics in those infected.
The study by Clementi, who is director of the microbiology and virology laboratory of San Raffaele, compared virus samples from COVID-19 patients at the Milan-based hospital in March with samples from patients with the disease in May.
“The result was unambiguous: an extremely significant difference between the viral load of patients admitted in March compared to” those admitted last month, Zangrillo said.
Oscar MacLean of the University of Glasgow’s Centre for Virus Research said suggestions that the virus was weakening were “not supported by anything in the scientific literature and also seem fairly implausible on genetic grounds.”
Experts and representatives of Johns Hopkins University, Wake Forest Baptist Medical Center, George Washington University and Northwell Health also said they were not aware of evidence suggesting that the virus had changed.
“The suggestion by the Italian doctor is potentially dangerous as it gives false reassurance based on no evidence,” said Leana Wen, an emergency physician and public health professor at George Washington University. “There is no scientific evidence for there having been a change in the coronavirus. It’s a highly transmittable and highly contagious disease. We need to be as on guard as ever.”
(Reporting by Emilio Parodi in Milan and Kate Kelland in London; additional reporting by Carl O’Donnell in New York; Editing by Josephine Mason, Peter Graff and Grant McCool)
© 2020 Reuters
Everything that happened in the first wave, only more so. Possibly much higher mortality if health care systems in a lot of places get badly overloaded (which would likely happen).
Swabs, not tests but yeah. Jeezloomer wrote: ↑2020-06-06 12:25pm Trump has, quite literally, single-handedly ruined thousands of COVID-19 tests.
Its most probably easier to manufacture swabs rather than testing kits, so the limiting factor is most likely not due to the swabs. But still not good.madd0ct0r wrote: ↑2020-06-06 12:29pmSwabs, not tests but yeah. Jeezloomer wrote: ↑2020-06-06 12:25pm Trump has, quite literally, single-handedly ruined thousands of COVID-19 tests.
As of right nowSweden won't ditch COVID strategy despite admitting errors
Rafaela Lindeberg
Jun 4, 2020 – 4.18pm
Save
Share
Stockholm | The scientist behind Sweden's controversial COVID-19 strategy says there's no need to change course, despite admitting that a different response earlier on might have saved lives.
Anders Tegnell, Sweden's state epidemiologist, triggered international headlines on Wednesday when he told a local broadcaster he would have adopted a different model to contain the virus at its onset, had he known then what he knows now.
The admission prompted members of Sweden's government to speak out, with the health minister, Lena Hallengren, demanding clarity. Tegnell "still can't give an exact answer on what other measures should have been taken", she told local media. Prime Minister Stefan Lofven has promised an inquiry into Sweden's response to COVID-19.
But in an interview in Stockholm on Wednesday, Tegnell said he had no regrets, and was "still confident" that Sweden's strategy "is working, in broad terms. But like any strategy, it needs to be adapted all the time".
Mr Tegnell is the mastermind behind Sweden's controversial approach to fighting the virus, and the government has deferred to him in its handling of the pandemic. Gatherings of more than 50 people continue to be banned, but throughout the crisis Swedes have been able to visit restaurants, go shopping, attend gyms and send children under 16 to school.
Mr Tegnell says he thinks it's now clear that closing primary schools was unnecessary, which he considers a key takeaway from the crisis.
But at 44 deaths per 100,000, Sweden's mortality rate is among the highest globally and far exceeds rates in neighbouring Denmark and Norway, which imposed much tougher lockdowns early on. Like elsewhere, the virus hit Sweden's oldest citizens hardest.
"We could have been better at protecting our care facilities. We could probably have tested a bit more than we did in the very beginning," Mr Tegnell said. More controversially, he rejects face masks as a useful protection against the virus. The evidence on face masks is "extremely vague", he said.
Despite the controversy, Mr Tegnell's strategy has enjoyed widespread support in Sweden. But with many other European Union countries now rolling back their lockdowns after appearing to bring COVID-19 under control, there are signs that Sweden may be left behind.
That's starting to mean less freedom of movement for Swedes, as some EU countries, including Cyprus and the Czech Republic, restrict access to people coming from what are deemed high-risk COVID zones. The Czechs lump travellers from Sweden and the UK into a "red group," meaning they pose the highest risk.
This has led to a subtle shift in the Swedes' mood in recent days, according to politicians and diplomats.
“Every week that goes by, the public discussion grows about the measures that have been taken or not,” said Hans Wallmark, a centre-right opposition MP.
He said the public were dismayed by three things: the high death toll in care homes that makes many people “almost ashamed”; the failure to deliver a mass testing scheme for COVID-19; and the closed borders for Swedes. “All those things are leading to a more critical discussion among Swedes,” he added.
Crucial to Sweden's approach to fighting COVID-19 is its universal healthcare system, Mr Tegnell said. "It makes a huge difference," he said.
Despite Sweden's high mortality rate, its hospitals have at no point been overwhelmed, and a field hospital erected at a convention centre in the capital has gone unused.
Ultimately, handling a crisis like COVID-19 requires regular adjustment if a country is to succeed in fighting it back, Mr Tegnell said.
"There are always improvements that can be made," he said. "Anybody who has been working with COVID-19 would say the same thing. Because if you don't improve with what you learn, you will never improve."
Bloomberg
The Tiny Data Firm at the Center of the Hydroxychloroquine Storm
By Helene Fouquet
and Robert Langreth
June 5, 2020, 6:25 a.m. EDT
The founder of Surgisphere Corp., a data analytics firm based outside Chicago, quoted Sun Tzu’s Art of War in remarks to Utah’s Western Governors University.
“Opportunities multiply as they are seized,” Sapan Desai told fellow graduates in 2012. Desai, who obtained an MBA and also holds a medical degree and a Ph.D., sought to apply the Chinese strategist’s advice to his own career.
Now the 41-year-old surgeon and entrepreneur is at the center of a controversy with global health implications. On Thursday, doubts about data from Surgisphere prompted the retraction of two scientific articles, including an influential study in The Lancet that had shown antimalarial drugs promoted by President Donald Trump could be harmful in the treatment of Covid-19.
The World Health Organization had suspended clinical trial programs using hydroxychloroquine following the initial report, as did the U.K. and France. The Lancet’s peer-reviewed study, published on May 22, claimed to have analyzed Surgisphere data collected from almost 96,000 Covid-19 patients across the globe.
The Letter
But in the days after publication, concerns over the underlying data bubbled up. Questions arose over how Surgisphere, a little-known company that claims to have 11 employees, could have reached agreements on sharing sensitive patient information with some 1,200 hospitals around the world, much less received and processed the data so quickly.
Last week, more than 200 scientists signed a letter to The Lancet asking for greater transparency regarding the hospitals where patients’ medical records came from and the method of analysis, citing a list of inconsistencies and anomalies in the paper.
Late Thursday, co-authors Mandeep Mehra, Frank Ruschitzka, and Amit Patel requested the paper be retracted after Surgisphere declined to submit its full dataset and other information to independent peer reviewers because of client and confidentiality agreements.
“Based on this development, we can no longer vouch for the veracity of the primary data sources,” the authors said.
Rush for Data
In a statement, The Lancet said many outstanding questions surround the company and the data used in the study. “Institutional reviews of Surgisphere’s research collaborations are urgently needed,” it said.
Shortly after, the New England Journal of Medicine retracted a separate study that relied on the company’s data.
The scrutiny has placed Surgisphere and Desai, who was listed as a co-author on both of the articles, under a microscope, and also raised questions about research standards during the coronavirus pandemic.
“There is an almighty rush to understand this new disease -- everybody is trying to get data quickly,” said Nicholas Day, a professor of tropical medicine at the University of Oxford’s branch in Bangkok. “All the journals are desperate to publish because there is a thirst to know about this disease. Therefore mistakes are made, stuff is rushed through.”
Desai and Surgisphere declined to comment on the retractions through a public relations firm.
Machine Learning
In emailed remarks before the articles were retracted, however, Desai defended his 12-year-old company, which consolidates medical records from around the world. He told Bloomberg the firm relied on artificial intelligence and machine learning to automate its processes, “which is the only way a task like this is even possible.”
“It is important to understand the nature of this database,” he added. “We are not responsible for the source data, thus the labor intensive task required for exporting the data from an EHR (electronic health record), converting it into the format required by our data dictionary, and fully de-identifying the data is done by the healthcare partner. Surgisphere does not reconcile languages or coding systems.”
No artificial intelligence or machine learning experts were listed as authors of the now-retracted Lancet paper. The article also indicated that of the four authors named on the study, Desai was the person who acquired and analyzed the data.
Headquartered in a residential house overlooking a small lake in an upscale area west of Chicago, Surgisphere has two branches that it says collect data and run machine learning software: QuartzClinical and Surgical Outcomes Collaborative.
Desai held positions in at least four medical centers following his Duke University surgery residency, according to his LinkedIn profile, and left his most recent position as a doctor at Northwest Community Hospital in Illinois in February.
Documents obtained by Bloomberg and filed by Desai in Illinois show him to be the sole owner of Surgisphere as of February. He didn’t respond to a query as to whether the company has a board or a scientific committee.
On Thursday, three employees were registered on LinkedIn as actively working at Surgisphere: a sales manager, a franchise representative and Desai himself. By Friday, following the retractions, only Desai remained.
A Sofia, Bulgaria-based computer scientist named Ivo Gelov, who told Bloomberg he had done part-time freelance programming for Surgisphere two years ago, said he had “no clue about their access to medical data.”
Data Questions
Scientists have highlighted potential inconsistencies in the data used in The Lancet study, from an unrealistically high number of electronic patient records in Africa to the doubtful origin of European figures given the continent’s strict rules around health privacy. Moreover, the dataset had more patients than would appear likely given the dates and progress of the virus, especially in the U.K. The Lancet last week published a brief correction of data from Australia.
Desai said the official figures “could have been under-reported early on during the pandemic, thus leading to the appearance that we are over-reporting numbers when in actuality we are capturing the true total number of Covid-19 infections at the hospital level, which is the true source for this data.”
Still, the Surgisphere studies were highly unusual in that they claimed to quickly assemble data from hundreds of anonymous hospitals, using numerous electronic medical records systems, under different privacy laws across many countries on multiple continents. And even more strangely, for studies that claimed a massive feat of data integration in record-setting time, they had no biostatisticians listed as authors that might have helped pull all this data together.
Health Records
More typically, when medical scientists do such studies they rely on clearly named and reputable government databases in one country or state that researchers are able to access.
Surgisphere said its information comes from “a registry, with data obtained from electronic health records” of a “very specific group of hospitalized patients with Covid-19.” The company “directly integrates with the EHRs of our hospital customers,” and “has permission to include these hospitals’ EHR data in its query-able registry/database of real-world, real-time patient encounters.”
Surgisphere didn’t provide the names of companies or institutions from which it obtained the data.
The retracted study published May 1 in the New England Journal of Medicine claimed to have records of 107 patients from five hospitals in France, including ethnic information such as skin color. However, it’s unlawful to collect such data in France. What’s more, the transmission or sale of hospital data and patient records are strictly limited, and often require approval by the CNIL privacy watchdog. The CNIL told Bloomberg it had not received requests from Surgisphere. The French health ministry didn’t immediately return an email seeking comment.
Scotland’s NHS
Surgisphere says on its website that it’s worked with Scotland’s National Health Service to find data-driven solutions to high rates of post-surgical complications and infections. No such relationship exists, the health agency said. “At no point have Surgisphere had any access to NHS Scotland data,” it said in an email.
As for Desai, in his remarks to Western Governors University, he paraphrased Britain’s wartime prime minister, Winston Churchill, on the importance of perseverance: “It is the challenges that teach us to never, never, never give in, to keep pressing forward no matter how hard it gets.”
It goes to show eradication can be done, if there is sufficient political will to do so. New Zealand closed its borders despite being heavily reliant on tourism. On the other hand, UK businesses are complaining because the government dared to impose a 14 days quarantine for incoming travellers.bilateralrope wrote: ↑2020-06-07 11:38pm New Zealand moves down to a level 1 lockdown tonight. That means the only restrictions remaining are:
- The borders are closed to most foreigners.
- Everyone coming into the country must spend two weeks in isolation in a government run facility. This includes testing them for Covid19
- Everyone is expected to keep a log of where they have been.
- Businesses are expected to keep a log of people who have visited them.
We have had 17 days in a row without a new case, and the last active case just recovered. So, unless there are some undetected cases lurking around or a case slips in from overseas, New Zealand's numbers are:
1154 confirmed cases, with 350 more probably cases that didn't get tested for a total of 1504 cases.
22 deaths
Also, some people are unhappy that ~50 people involved in filming Avatar 2 got allowed into the country. Though I'm thinking that will be good for the economy, as everyone else involved in the film will have to be hired locally.
There's a fair bit of sunk-cost fallacy going on in most countries.bilateralrope wrote: ↑2020-06-08 05:36am Question is: Will New Zealand's success lead to any other countries changing their strategy ?
That's omitting the most important part, which is New Zealand being an island in terms of ingress. Similar to other small nations (like Israel) that are coping well with the outbreak, they had the ability to easily and quickly shut borders.ray245 wrote: ↑2020-06-08 05:17amIt goes to show eradication can be done, if there is sufficient political will to do so. New Zealand closed its borders despite being heavily reliant on tourism. On the other hand, UK businesses are complaining because the government dared to impose a 14 days quarantine for incoming travellers.bilateralrope wrote: ↑2020-06-07 11:38pm New Zealand moves down to a level 1 lockdown tonight. That means the only restrictions remaining are:
- The borders are closed to most foreigners.
- Everyone coming into the country must spend two weeks in isolation in a government run facility. This includes testing them for Covid19
- Everyone is expected to keep a log of where they have been.
- Businesses are expected to keep a log of people who have visited them.
We have had 17 days in a row without a new case, and the last active case just recovered. So, unless there are some undetected cases lurking around or a case slips in from overseas, New Zealand's numbers are:
1154 confirmed cases, with 350 more probably cases that didn't get tested for a total of 1504 cases.
22 deaths
Also, some people are unhappy that ~50 people involved in filming Avatar 2 got allowed into the country. Though I'm thinking that will be good for the economy, as everyone else involved in the film will have to be hired locally.
The UK and Ireland are island nations as well. They didn't do as well as other places. Most infection didn't seem to travel via land borders, but via air travel. So whether you can contain and eradicate the virus depends purely on your ability to respond as quickly as possible.
This is going to be a mess. And it's going to be harder for the left to challenge Trump on it in part due to the protests. Months of effort in trying to contain the virus has gone down the drain.Trump to restart MAGA rallies this month despite coronavirus
Donald Trump is planning to restart rallies in the next two weeks in a major turning point for the president since the coronavirus shut down traditional campaigning.
Trump’s advisers are still determining where the rallies will take place and what safety measures will be implemented, depending on the type of venue chosen. Campaign manager Brad Parscale is expected to present Trump with possibilities within the next few days.
The president has been itching to resume his boisterous rallies, his favorite way to connect with supporters and let off steam. He's planning to use the events to drive home what is expected to be a major theme of his campaign: that he is the leader of the country’s reopening and economic rebound. Trump held a hastily-called press conference Friday to celebrate an unexpectedly strong jobs report, and his campaign immediately began running a massive ad campaign seizing on the news.
“Americans are ready to get back to action and so is President Trump. The great American comeback is real and the rallies will be tremendous,” Parscale said in a statement. “You’ll again see the kind of crowds and enthusiasm that sleepy Joe Biden can only dream of.”
The move comes at a precarious moment for Trump. National and swing state polls show him taking a major hit amid his handling of the pandemic and the social unrest that followed the killing of a African American man at the hands of Minnesota police. He is trailing Joe Biden substantially in many polls.
The president’s team views the rallies as a way of rejuvenating his base and displaying the enthusiasm behind his reelection bid. They are eager to create a contrast with Biden, who has largely remained secluded in his Delaware home and hasn’t held a major campaign event since spring.
While Trump is likely to face blowback for resuming in-person events while the coronavirus pandemic is still ravaging the country, his advisers contend that the recent massive protests in metropolitan areas will make it harder for liberals to criticize him.
Trump hasn’t held a rally since March, though in recent weeks he has used ostensibly official events to visit swing states. He is gradually returning to normal political life, with a pair of in-person fundraisers scheduled for this month. He will headline an event Thursday at a private home in Dallas.
Aides are factoring in an array of factors in determining where the rallies will be held, including the number of coronavirus cases that exist locally.
With the election less than five months away, there's a growing sense of urgency within the Trump campaign. It has recently taken steps to beef up its infrastructure, elevating longtime political adviser Bill Stepien and bringing on Jason Miller, a key figure on Trump’s 2016 bid. The staff moves are intended to provide additional support to Parscale, who has been campaign manager since 2018.
You know what? If Trump wants his fanclub to put their lives in danger to massage his ego then let them, if they're foolhardy enough to go along with it. If nothing else I don't see why his enemies should be the only ones sticking their necks out for their cause.
You do know they'll spread it to a lot of other people and overworked health workers, right?
You know a whole bunch of transport workers are going to end up catching the disease and dying as a result? This isn't about the left or right getting the virus. A whole bunch of vulnerable people are going to catch it because they either have to work ( in essential services), or they will end up catching if it they have to go out to buy groceries or medicine.
Even in GOP states, large gatherings are still by and large uncommon, because everything was still shut. Those that refuse to listen and open churches are the ones catching the virus. There was some protests by the far-right, but they were tiny protests compared to the BLM protests. Election rallies on the other hand, are an issue because they are going to take place on a far larger scale than your average "open-up" protests.Zaune wrote: ↑2020-06-08 07:58pm Oh, I know. But that horse left the barn long ago; the people showing up to these rallies were probably ignoring the lockdown rules from Day 1 even if they weren't marching along Main Street toting AR-15s and threatening to murder anyone who tried to enforce them. And that's in states where the GOP didn't manage to carve out enough exemptions to make the whole exercise largely futile in the first place.
The problem is there will be a huge massive spike in deaths throughout the country that could be worse than the initial wave. It will be far harder to re-impose a second lockdown in the US, and even New York which was hit hard have not come close to herd immunity, at only about 20 percent.Besides, we can hardly argue that the mass protests are an important enough issue to justify abandoning quarantine but only for one side. And the idea of Black Lives Matter protestors putting themselves at risk to push back against a decades-long catalogue of abuses of power while people who earnestly believe that black lives don't matter get to sit at home drinking beer and cheering on the cops "for their own safety" frankly sickens me.