C19 Notes

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41
C19 Notes Database / A reminder why we have restrictions and wear a mask
« Last post by stog on December 15, 2020, 11:05:12 AM »
Here is a reminder why we have restrictions, lockdowns and having to endure very real Economic hardships .

Why we are having to wear a mask, keep physically distant and observe good ventilation.

If left to its own devices Covid would overwhelm our Services. here is a back of an envelope calculation i did for a UK anti-masker who turned out NOT to know that asymptomatic spread is highly contagious as of course  are pre-symptomatics.


42
C19 Notes Database / Pfizer’s Vaccine Offers Strong Protection After First Dose
« Last post by stog on December 08, 2020, 04:14:49 PM »
Pfizer’s Vaccine Offers Strong Protection After First DoseThe Food and Drug Administration’s first analysis of the clinical trial data also found that the coronavirus vaccine worked well regardless of a volunteer’s race, weight or age.

good info here -- u can simply sign in to the New York Times with facebook to view the article
https://www.nytimes.com/2020/12/08/health/covid-vaccine-pfizer.html

ERic in the post btw is Epidemiologist & Health Economist. Senior Fellow. Fmr 16 yrs @Harvard
. Fmr drug safety whistleblower

==

it's looking good so far -- but as with all vaccines --time really tells -- the article gives some good info but as a virologist/vaccine maker once said

"i'm only really happy if no problems after the Billionth shot"

the article describes initial temporary symptoms which seem to fade and the vaccine is not recommended for pregnant or nursing mothers or U16s

43
C19 Notes Database / Re: Lateral Flow Test LFD Accuracy
« Last post by stog on December 03, 2020, 10:54:55 AM »
a Image

a Biostatician posted the above on Twitter today (taken from https://www.gov.uk/government/publications/community-testing-explainer/community-testing-a-guide-for-local-delivery#what-the-community-testing-programme-is ) saying

Quote
Mass testing in Liverpool MISSED ~50% of infections and ~30% with high viral loads.  Results are in this Government document, but no actual numbers or details are given. Absolutely URGENT that @DHSCgovuk  reports full data today and HALTS IMPLEMENTATION

i replied that
Quote
thx 4 posting LFD are indeed just a guide, son has just had one b4 leaving Uni- we must still maintain distance forweek really re symptom testing best is the very diagnosis of symptoms which points more accurately to C19 than any test & requires case to isolate 10 days from onset

44
C19 Notes Database / Re: Treatment & Vaccine Database
« Last post by stog on November 29, 2020, 09:35:28 AM »
This vaccine tag search is very good for overview of all interim vaccine trials as they come through.
https://www.sciencemediacentre.org/tag/vaccines/
45
C19 Notes Database / Re: Vaccines Problems and reasons
« Last post by stog on November 29, 2020, 09:20:46 AM »
This vaccine tag search is very good for overview of all interim vaccine trials as they come through.

https://www.sciencemediacentre.org/tag/vaccines/
46
C19 Notes Database / Lateral Flow Test LFD Accuracy
« Last post by stog on November 26, 2020, 09:08:48 AM »
Scientists urge caution on use of lateral flow tests to screen for Covid-19
useful info here for anyone picking up students from Uni returning home for Christmas who are taking LFD tests -- lateral flow tests.
use only as a guide. a sensible approach from my brother in Law who has both sets of elderly parents coming for Xmas is that both sets need to properly isolate for a week before coming, thus protecting all and reducing risk.
Similarly a student returning home, even with a negative test should remain 'distant' for the first week.
Quote
"Jon Deeks, a professor of biostatistics at the University of Birmingham, said that the test is ‘entirely unsuitable’ for community testing, such as that planned for university students in the run-up to Christmas. ‘As the test may miss up to half of cases, a negative test result indicates a reduced risk of Covid, but does not exclude Covid,’ Deeks added. ‘This evidence raises serious concerns that the benefits are likely to be few, with serious risk of harm if the public are misled by unjustified government claims of this test’s high performance.’
 Deeks pointed out that the report’s headline figure of 76.8% sensitivity mixes data from different settings. One study of Innova’s device at a testing centre found that the device appeared to miss one out of every two Covid-19 cases (58%). Another study using nurses to test patients suggests it missed one out of every four cases (73%)."
there are more enthusiastic articles and research which i shall add below, but it would seem these tests are a 'guide' and should not be considered definitive -- as with so much Covid info!!

https://www.chemistryworld.com/news/scientists-urge-caution-on-use-of-lateral-flow-tests-to-screen-for-covid-19/4012763.article


this is one of the source papers https://www.bmj.com/content/371/bmj.m4262

and this is a readable extract
https://www.ox.ac.uk/news/2020-11-11-oxford-university-and-phe-confirm-lateral-flow-tests-show-high-specificity-and-are#

this is the more negative evaluation
https://www.bmj.com/content/371/bmj.m4323
47
C19 Notes Database / Light at the End of the Tunnel
« Last post by stog on November 02, 2020, 09:44:12 AM »
Light at the End of the Tunnela paper from the Global Institute , foreword by Tony Blair, that examines some of the options we have as we head into our second UK/EU lockdown

"
Quote
Britain, along with virtually every other country on the continent of Europe, is at an absolutely critical juncture in its response to the Covid-19 pandemic. This paper identifies the vital decisions which need to be taken now.The second wave in terms of cases could be as large or even larger than the first.Britain, like other countries, has taken the decision to go back into lockdown.The essential challenge, which we must meet, is to use November to re-emerge in December with this lockdown being the last.In this paper we suggest that there is a plan involving accelerated deployment of therapeutic drugs and vaccines, mass testing using all available new tests, together with the best data system globally accessible, which would allow us in December to close off resurgence of Covid-19 when we come out of lockdown.At the very least, we raise the questions the government needs urgently to interrogate and answer.The first wave has already had an economic cost roughly three times that of the financial crisis. The consequence of a further round of lockdowns will be devastating.I am optimistic that by the second quarter of next year we will have vaccines and therapeutic drugs which will allow us to manage the disease and return to something like normal.My anxiety is between now and then. We simply can't afford to put our society and economy into severe restrictions for the winter months. The toll in terms of health and the economy will be enormous.





https://institute.global/policy/light-end-tunnel
49
C19 Notes Database / Home management of Covid and Virtual Ward Toolkit
« Last post by stog on November 01, 2020, 02:35:08 PM »
An optimistic post this
so many people worldwide are working on Covid, diagnosis treatment management as well as vaccines etc
i came across this superb initiative today which helps to prevent Hospitals becoming overloaded by means of better diagnosis, treatment and management at home with the use of oximeters - SATS monitors and recording daily levels etc . As a clinical finding of a low sats % is fairly indicative of Covid, I originally was wary that various vulnerables and smokers etc actually function on lower sats levels in their daily lives, so it seemed important that base levels, their normal levels were known, so that there wouldn't be a knee jerk response of Covidity.
Anyhow then i came across these Virtual Ward models which have been piloting so well in the Southampton areas and beyond.
There is a recorded Zoom presentation/webinar (brilliant fella onboard Dr Matt Inada-Kim, Hampshire Hospitals NHS Foundation Trust, presents Covid virtual wards) on this page which will be very useful for Practitioners like ourselves who are currently practising (we are not, but we are still involved with supporting those that are)
The link also has the resources that can be downloaded as well as the latest triage slides being used which help with the latest symptomatology along with clinical signs and findings.
If we were currently working i would be adding SATS readings now as a default to all case histories along with BP and pulse and the myriad of other info we usually record when we examine & Ortho-test on consult and treat.

https://wessexahsn.org.uk/projects/388/covid-oximetry-at-home-toolkit
50
C19 Notes Database / Re: Doctors rethink rush to ventilate
« Last post by stog on November 01, 2020, 01:23:52 PM »
good latest info on case care at home and sats levels within virtual wards
Covid Oximetry at Home Toolkit   Programme(s):
 Covid Oximetry at Home (virtual ward)   

he Covid Oximetry at Home work (sometimes called a "virtual ward") describes an enhanced package of care for individuals with confirmed or suspected Covid-19 who are at risk for future deterioration.

The package of care involves the remote monitoring of the individual's condition through providing regular contact with a local health care team who will reassess the individuals symptoms (including oxygen saturation levels). This close monitoring enables the individual to remain at their usual place of residence whilst allowing early signs of deterioration to be identified and escalated quickly and appropriately.

This material has been designed primarily for use across the South East AHSN network by colleagues within the Wessex AHSN, Kent Surrey Sussex AHSN and Oxford AHSN regions. Colleagues from regions beyond the South East are also very welcome to make use of this toolkit in setting up their own local approaches to remote monitoring.

https://wessexahsn.org.uk/projects/388/covid-oximetry-at-home-toolkit
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