Coronavirus (COVID-19)

[madwullie]

Just now, Honest_Man#1 said:

You’ve really changed your tune from the “AH’LL BE AT THE SHOPS WITH MY WIFE WHETHER THEY WANT ME TO OR NOT” days.

I’m far from a COVID denier, but it is utterly moronic to just go straight for a full month lockdown based on... something.

What is your reasoning for another full lockdown? Do you want us to continue with full lockdowns for a period, then relax for a period, then back to full lockdowns etc indefinitely?

What other solutions are there to stop the nhs being overwhelmed?

It would be better if they relaxed the restrictions once it was clear it won't be overwhelmed () and actually use the time to prepare / plan for coming out of lockdown and attempt to stop it from happening again, but right now (in England) , what else can they do? 

[Cyclizine]

33 minutes ago, Distant Doonhamer said:

That’s interesting because although hugely concerned the couple of critical care docs I still speak to are much more worried about morale and the effects of Covid restrictions on other services rather than about capacity issues per se. Presumably some variation between the regions. I’m not in the central belt.

Edit to add I understand all critical care units have escalation policies in case of another surge. Fully accept it’s not just about physical space but the difficulty of staffing and the huge impacts that makes on other services e.g. again shutting down all but emergency surgery.

Although we've seen an increase in Covid numbers in our unit, there has been a bigger increase in the usual winter admissions. This is complicated by the need to run separate "hot" and "cold" units, which means staffing is stretched as they're in separate sites. We're running over the usual bed capacity as well in total numbers.

My colleagues in general medicine are taking the Covid hit at the moment. We've learnt somewhat from the first wave that non-invasive ventilation and high-flow oxygen can be effective treatment. Previously, we would invasively ventilate the majority.

There is undoubtedly going to have a knock on effect again on elective surgery: high risk cases can't be done without critical care back up and more staff will be redeployed to cover critical care. As has been previously mentioned, morale is rock-bottom. Staff are burning out and we are seeing more off sick.

[Honest_Man#1]

Just now, madwullie said:

What other solutions are there to stop the nhs being overwhelmed?

It would be better if they relaxed the restrictions once it was clear it won't be overwhelmed () and actually use the time to prepare / plan for coming out of lockdown and attempt to stop it from happening again, but right now (in England) , what else can they do? 

The current Scottish statistics and forecasts for the majority of health boards suggest they are not at risk of being overwhelmed, either in hospital overall capacity or ICU capacity.

Based on that, why should we go into a national “full lockdown” as Granny suggested? Why would we not just target the areas that are actually deemed to be at risk?

[Granny Danger]

2 minutes ago, Honest_Man#1 said:

You’ve really changed your tune from the “AH’LL BE AT THE SHOPS WITH MY WIFE WHETHER THEY WANT ME TO OR NOT” days.

I’m far from a COVID denier, but it is utterly moronic to just go straight for a full month lockdown based on... something.

What is your reasoning for another full lockdown? Do you want us to continue with full lockdowns for a period, then relax for a period, then back to full lockdowns etc indefinitely?

My reasoning is that the other options are not working.  I don’t think it’s practical to wait until the ICUs are bursting to capacity and other, essential, non-Covid treatments cannot be carried out in hospitals before we take the necessary action.

I appreciate you engaging rather than just red dotting.

 

[Inanimate Carbon Rod]

8 minutes ago, superbigal said:

28 minutes ago, madwullie said:

Fire in Hairmyres the other day in ward one which was a covid icu. Everyone was OK, and patients were safely moved into the "clean" icu. Unfortunately now all the nurses that were in the clean icu have to isolate for 14 days  

If they had been wearing correct ppe for situation they would not have to isolate.

You do know that if it wasnt for a couple of things, namely a very brave doctor fighting the fire themselves without a thought for their own safety and staff having to remove central lines and basically drag people out the ward immediately then we’d be looking at a massive loss of life? 
Covid ward or hemmoragic fever ward whatever, aint no body got time for dat ppe. 

[Inanimate Carbon Rod]

3 minutes ago, Marshmallo said:

We never had a "full lockdown" in this country at any point. You had folk piling into cars to buy yoghurts 30 miles from their house, going to 'Big Licks' for ice cream 5 nights a week and 25 folk in gardens when the R rate was sky high and 1,000 folk a day were dying in the UK from covid.

See had everyone just not been a selfish c**t through this then the first wave would have been much easier. I dont think a second lock down will be effective, basically people are still going to parties etc and ignoring the rules, the government havent equipped for proper enforcement of this in their approach and think that the idiots who ignore house party restrictions etc will listen to reason and the ‘educate, explain’ approach.
 

[Distant Doonhamer]

What other solutions are there to stop the nhs being overwhelmed?
It would be better if they relaxed the restrictions once it was clear it won't be overwhelmed () and actually use the time to prepare / plan for coming out of lockdown and attempt to stop it from happening again, but right now (in England) , what else can they do? 

Are you saying we need/should have a lockdown in Scotland now?
Numbers of Covid patients in hospital in Scotland look like they are beginning to plateau and a hint that critical care numbers may be beginning to fall, certainly no increase in the last week and at 80-90 nowhere near the peak of earlier in the year. The situation in England does look very different atm.

[LinkinFighter]

11 minute mark for schools must stay open in their current guise crowd. 

 

 

Edited October 31, 2020 by LinkinFighter

[Inanimate Carbon Rod]

1 minute ago, Tynierose said:

One of our practice managers response to staff being stressed and morale being low was an inspirational tough.

It's the same staff battling through but good will only goes so far and morale has crashed.   I know this is the same in other areas.

I don't mind admitting I'm close to burn out.   I have around 30 patient appointments a day, a mix of over the phone  and face to face, these days none are nice wee simple things due to other pressures on services.  Add in dealing with referrals, docman results etc its bloody hard going, especially the doc man results as that leads to more prescriptions, paperwork etc and due to more staff being off you're trying to squeeze in more.   Factor in a few mental healtg patients and its draining.

I'm struggling to see how things improve over the coming months.

 

If this pandemic has highlighted anything imo its that instead of boasting about the NHS we need to look very closely at it and see just how badly it’s struggling, we need to invest heavily in it, we need to ramp up mental health provision, care of the elderly and widen the access for primary practitioners like yourselves to get patients through to secondary services. You’ve mentioned referrals from last year going untouched, my wife’s practice is largely the same, thats in two different parts of the country, suggests a very wide spread problem. 

I can relate to the feeling of being burnt out, constantly seeing people flout the rules yet constantly getting grief over other peoples selfishness etc has been very draining, that plus added pressures with people across the public sector essentially using the virus as an excuse to not do their fair share has led to a massive degree of pressure across the NHS and other emergency services.

I struggle too, not ashamed to admit ive felt my own mental health decline to a point where ive felt overwhelmed on a few occasions at home, have kept it together at work as a manager I have to, but if I didnt have a supportive partner and family I dont think Id manage.  I think im clinging to the hope of a vaccine starting to get rolled out, its the constant not knowing, I know its not the way it works but if I just knew this would be over by x,y,z I could maybe feel better about it. 
 

Regardless I think we need to see massive spending increases in health and social care in this country or next covid ‘20’ or whatever will burst everything. That plus it’s pretty much the right thing to do, happy well cared for population = a hard working, healthy population which in the longer term will be much better. 

[Have some faith in Magic]

Reading Nicola Sturgeons latest tweets I think we are are all about to jump into tier 4. 

 

 

[Distant Doonhamer]

My reasoning is that the other options are not working.  I don’t think it’s practical to wait until the ICUs are bursting to capacity and other, essential, non-Covid treatments cannot be carried out in hospitals before we take the necessary action.

I appreciate you engaging rather than just red dotting.

 

If we look at Covid hospital admissions and Critical Care Covid numbers then there is early evidence that the other options are having an effect. Hospital numbers are plateauing or at worst increasing very slowly and critical care Covid numbers look like they are beginning to fall, certainly haven’t increased in the last week (down from 90 to 83 in the 5 days to yesterday). If we think the Scottish R number is important (not everyone does) it was 1-1.3 on 29th October, having been 1.2-1.5 on 22nd October and 1.3-1.6 on 15th October.

The hospital numbers of course may go up again but I don’t see anything to suggest we need a Scotland wide lockdown now.

[doulikefish]

1 minute ago, Have some faith in Magic said:

Reading Nicola Sturgeons latest tweets I think we are are all about to jump into tier 4. 

 

 

 

[Szamo's_Ammo]

3 minutes ago, doulikefish said:

 

Supermarket Cheddar fan imo.

Edited October 31, 2020 by Szamo's_Ammo

[doulikefish]

1 minute ago, Szamo's_Ammo said:

Supermarket cheddar fan imo.

That boy follows loads of celebs/politicians etc on twitter and just asks that question to them all

[LongTimeLurker]

44 minutes ago, Granny Danger said:

Seems like the Covid deniers prefer red dots to rebuttal.  

What on earth are you gibbering about? Being opposed to your asinine suggestion on having a drastic lockdown is not the same thing as thinking it doesn't exist.

[highlandcowden]

1 minute ago, doulikefish said:

That boy follows loads of celebs/politicians etc on twitter and just asks that question to them all

top quality bants from him,wish i was on twitter

[Szamo's_Ammo]

19 minutes ago, LongTimeLurker said:

What on earth are you gibbering about? Being opposed to your asinine suggestion on having a drastic lockdown is not the same thing as thinking it doesn't exist.

That poster is in their 60s and gets seriously upset about people clicking downward pointing arrows within red circles on this forum.

If you don't support every single thing the Scottish Government does then you are a Covid denier!

Better off ignoring their inane ramblings on most issues imo.

Edited October 31, 2020 by Szamo's_Ammo

[Detournement]

15 minutes ago, Have some faith in Magic said:

Reading Nicola Sturgeons latest tweets I think we are are all about to jump into tier 4. 

 

 

If she does that now she loses any credibility that she isn't just reacting to events in England.

[Thereisalight..]

I’ve only just read that Leitch won a science award. The man that originally said face masks were basically ineffective and then did a u turn, the condescending p***k we have to listen to on TV/Radio adverts 8 months in telling us to wash our hands and stay 2 metres apart. Holy fck as if 2020 couldn’t get any weirder! The “guys” and those appearances on Off the ball really did work wonders! 

[Distant Doonhamer]

Although we've seen an increase in Covid numbers in our unit, there has been a bigger increase in the usual winter admissions. This is complicated by the need to run separate "hot" and "cold" units, which means staffing is stretched as they're in separate sites. We're running over the usual bed capacity as well in total numbers.

My colleagues in general medicine are taking the Covid hit at the moment. We've learnt somewhat from the first wave that non-invasive ventilation and high-flow oxygen can be effective treatment. Previously, we would invasively ventilate the majority.

There is undoubtedly going to have a knock on effect again on elective surgery: high risk cases can't be done without critical care back up and more staff will be redeployed to cover critical care. As has been previously mentioned, morale is rock-bottom. Staff are burning out and we are seeing more off sick.

Yes that all makes sense. It’s a huge challenge to all concerned and it’s no surprise that morale is very low. My initial response to Tynierose was really to clarify that the Critical Care numbers for Covid weren’t that high compared to previously. The lessons learnt earlier re non-invasive ventilation and high flow oxygen rather than early invasive ventilation are hugely important but as you say to a large extent just shifts some of the load to other clinical areas. As I’ve highlighted in other posts there is just a hint that Covid numbers in hospital are beginning to plateau. Hopefully that is so and we may even start to see a slow decrease in these numbers again. That’s not for a second to underestimate the huge challenges involved in both primary and secondary care settings. Good luck and stay safe.