Coronavirus outbreak

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PK99

Legendary Member
Location
SW19
Has anyone seen any data differentiating patients dying OF and dying WITH Covid -19?
 

tom73

Guru
Location
Yorkshire
Trust guidelines for Mrs 73 have been updated they've now been told to wear long sleeve apron. For all resus situations she been busy updating the response kit's. Which look's to be in line with resus council guidelines.
 

Venod

Eh up
Location
Yorkshire
Has anyone seen any data differentiating patients dying OF and dying WITH Covid -19?
I have not seen any, figures on this, the below is copied from the article I linked to upthread from the spectator, the problem I have with this is if Flu is not put down as the cause of death, how are the Flu death statistics compiled.


But there’s another, potentially even more serious problem: the way that deaths are recorded. If someone dies of a respiratory infection in the UK, the specific cause of the infection is not usually recorded, unless the illness is a rare ‘notifiable disease’. So the vast majority of respiratory deaths in the UK are recorded as bronchopneumonia, pneumonia, old age or a similar designation. We don’t really test for flu, or other seasonal infections. If the patient has, say, cancer, motor neurone disease or another serious disease, this will be recorded as the cause of death, even if the final illness was a respiratory infection. This means UK certifications normally under-record deaths due to respiratory infections.
Now look at what has happened since the emergence of Covid-19. The list of notifiable diseases has been updated. This list — as well as containing smallpox (which has been extinct for many years) and conditions such as anthrax, brucellosis, plague and rabies (which most UK doctors will never see in their entire careers) — has now been amended to include Covid-19. But not flu. That means every positive test for Covid-19 must be notified, in a way that it just would not be for flu or most other infections.
 

winjim

Smash the cistern
Trust guidelines for Mrs 73 have been updated they've now been told to wear long sleeve apron. For all resus situations she been busy updating the response kit's. Which look's to be in line with resus council guidelines.
It'll be interesting to see what things are like when I get back to the lab. Obviously we treat all samples as a potential infection risk but I think COVID-19 has been designated a category 3 pathogen requiring special precautions, so if we are going to treat every patient as potentially infected, things could get difficult.

For reference, cat 3 includes things like HIV and Hepatitis C and requires special precautions in the lab. The next one up, cat 4, is stuff like Ebola, requiring specialist facilities not available in most hospital laboratories.
 

newfhouse

Resolutely on topic
This ethics discussion on Radio 4 this morning was an interesting listen. I’m still not sure where I stand on how care will need to be rationed, and I’m glad I won’t have to make such judgements. First come, first served? Age? Chance of survival? Perceived societal value? Horrific choices, all.
 
Seems a lot people are questioning the UK govt this morning - asking "what actually is ramping up " in practical terms.

Somebody from the chemical industry - has said there is no shortage of chemical s for the test - they could provide them if asked......

Me - I'm just hoping the extra ventilators aren't the same truck as the test kits, as that seems to have stuck somewhere for around 3 weeks now !
 
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Unkraut

Master of the Inane Comment
Location
Germany
I’m still not sure where I stand on how care will need to be rationed, and I’m glad I won’t have to make such judgements.
Guidelines have been published here in case necessary, and a similar discussion last night. It is important that patients are not panicked into thinking if they are old they will not receive treatment, and doctors need to be relieved of the fear that the public prosecutor could be after them for decisions made leading to a death.

The criteria for deciding who gets treated when rationing includes not treating where survival is virtually impossible, then where it is unlikely to lead to a normal life again. Social status is to regarded as irrelevant. Patients who would require a long term level of intensive care after initial treatment would also be excluded. Decisions must be made by more than one doctor and also involve other staff as appropriate or possible.
 
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wafter

I like steel bikes and I cannot lie..
Location
Oxford
Is anyone else concerned by the deaths to recovery ratio being recorded for Britain? As they currently stand, the Public Heath England figures cite 1789 deaths and 135 recoveries from 25150 confirmed cases. This means that of all the "concluded" cases (i.e. all those that have resulted in either death or recovery) the vast majority (around 92%) are deaths.

I appreciate that recoveries might take longer to confirm than deaths (the former requiring a certain symptom-free period to be sure, while death is pretty obvious and conclusive!). It's also possible that this could also be explained by a low proportion of tests being carried out; and if so most likely being administered only in the most severe of cases (i.e. when people are admitted to hospital, which seems to be the case currently).

Still, I find this very concerning since every other country shows a much higher proportion of recoveries to deaths, with even Italy recording only around 45% of "concluded" cases as resulting in death compared to our 92%. This trend has also been fairly consistant throughout the whole process in both countries (as illustrated nicely in Wikipedia's timeline bar charts for both the UK and Italy); rather than showing any lag. Perhaps Italy's process for confirming recoveries are less stringent than ours?

This is also worrying given that we currently have around 25k confirmed cases and following Italy's example it's likely that this will increase by a factor of four or five before it levels out. If the mortality rate remains as it is now we're looking at the vast majority of those cases resulting in death, so potentially in the region of 100,000 fatalities :blink:

Can anyone shed any more light on this please?
 

mjr

Comfy armchair to one person & a plank to the next

Unkraut

Master of the Inane Comment
Location
Germany
@wafter You cannot simply compare Italy and the UK or other countries. Deaths as a percentage of confirmed cases does not cover all those who have had the disease and who have recovered. The number of tests being made makes a vital difference. I suspect the UK has been aiming tests at those who already have serious symptoms, due to lack of capacity. The German death rate is comparatively low, but much larger numbers have been tested than elsewhere to date.
 
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Johnno260

Guru
Location
East Sussex
This ethics discussion on Radio 4 this morning was an interesting listen. I’m still not sure where I stand on how care will need to be rationed, and I’m glad I won’t have to make such judgements. First come, first served? Age? Chance of survival? Perceived societal value? Horrific choices, all.

I would imagine pure chances of survival, health issues vs clean bill of health.

Whatever the guidelines I don’t envy anyone having to make those calls.
 
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