Coronavirus (COVID-19)

[Steven W]

8 minutes ago, Glen Sannox said:

That looks really encouraging. Surely we are finally winning this battle.

I do hope so.

But let's face it, the numbers are coming down owing to lockdown.

We'll only really know if we're winning the battle when we eventually open up and judge at that point.

Question is, when will we open up and who will be brave enough to do it first. The rhetoric coming from down south suggests that Scotland might have to go first this time. If Sturgeon has it in her.

[Cyclizine]

1 hour ago, virginton said:

And what is the most efficient way of determining how these drugs work in practice, right now? It is not 'wait and see for a randomised trial to be completed and the results written up'. While that provides the most authoritative evidence, it does nothing to address the actual pandemic ripping through your population in the meantime. 

The most efficient way? A randomised controlled trial. Like the RECOVERY trial, which if you actually go and have a look at how quickly it was set up and how quickly we have got good data about efficacy and safety is nothing short of miraculous. You don't seem to get the fact that if you administer random drugs to patients, with no rhyme nor reason, with no follow-up, with no collection of data, how can you possibly assess how they work?

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I am referring specifically to the dexamethasone treatment that has already been shown to benefit critical patients though. I'm not talking about an ibuprofen or countless other completely different products, so this is a straw man argument. 

You've changed your tune there. You only mentioned nebulous "anti-inflammatories". The utility of dexamethasone was proven by the RECOVERY trial in a remarkably short time period.

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Having already established that a specific anti-inflammatory improves outcomes in critical patients, they should be firing that out to vulnerable groups on testing positive and asking questions about the overall impact of that treatment later. 

No they shouldn't. What works in one population may not work in another, like dexamethasone, which is only of benefit if you require supplemental oxygen. Any "firing out" should be done in the context of a trial. Drugs can have negative side effects when used outwith their indications, which I'm sure you learned in your first-year medical school pharmacology lectures.

[RH33]

2 hours ago, 101 said:

If that's true, I'm not sure you should a, know about it and b, stick it on a football forum

It’s the highland it’s hardly going to take someone with the brain power of virginton to work it out!

I’d hazard a guess Dr Frey’s in Elgin is also a store!

[Shadow Play]

20 minutes ago, Marshmallo said:

Behave

Sorry, you've genuinely lost me there.  Are you definitely saying things may not get a lot worse?

[Todd_is_God]

13 minutes ago, Shadow Play said:

Sorry, you've genuinely lost me there.  Are you definitely saying things may not get a lot worse?

Why would they?

We have a vaccine that is being rolled out to those most likely to be seriously ill from it, and a lockdown in place until we get through that same group.

No reason to believe we should ever be in a worse position than we are at the moment.

Edited January 24, 2021 by Todd_is_God

[vikingTON]

34 minutes ago, Cyclizine said:

The most efficient way? A randomised controlled trial. Like the RECOVERY trial, which if you actually go and have a look at how quickly it was set up and how quickly we have got good data about efficacy and safety is nothing short of miraculous.

No, that's not the most efficient way at all, because in the intervening period an estimated 100k people have died, ICU wards are full to bursting point and the entire country is in version 17 of a rolling lockdown. All while there have been precisely zero medications prescribed to try and reduce the number of cases in the community who will end up requiring hospital treatment. 

While the medical development of treatment has been quick (and in the case of vaccines, an enormous success), it has therefore not been quick enough. An airborne pandemic does not wait for the results of controlled trials.

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You don't seem to get the fact that if you administer random drugs to patients, with no rhyme nor reason, with no follow-up, with no collection of data, how can you possibly assess how they work?

Except that it's not a 'random' drug at all. It involves prescribing the same drug that is already used for months to treat Covid in hospitals, to deal with cases in the community as well. As opposed to twiddling our thumbs for three weeks until a portion of them inevitably require treatment in hospitals that are already under severe pressure.

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No they shouldn't. What works in one population may not work in another, like dexamethasone, which is only of benefit if you require supplemental oxygen. Any "firing out" should be done in the context of a trial. Drugs can have negative side effects when used outwith their indications, which I'm sure you learned in your first-year medical school pharmacology lectures.

Of course drugs can have negative side effects. But these have to be weighed up against the wider societal costs of not applying any single medical intervention short of hospital treatment: a strategy that has utterly failed in the UK context. In the context of a pandemic overwhelming our public health system - that is causing negative impacts on almost every other category of health care - the premise that we cannot possibly risk harming Covid patients is irrational and should be binned. You act first based on the evidence and reason that you do have and then adjust best practice as trial data comes in as well. 

Edited January 24, 2021 by vikingTON

[Shadow Play]

7 minutes ago, Todd_is_God said:

Why would they?

We have a vaccine that is being rolled out to those most likely to be seriously ill from it, and a lockdown in place until we get through that same group.

No reason to believe we should ever be in a worse position than we are at the moment.

I’m not saying things will get worse.  That’s why is used the word “may” and not “will”.

I have a family and friends and I do worry (not overly but it is a concern) that a future mutation of COVID could prove more fatal and / or render the vaccinations less useful.

Once again, to clarify, I’m not saying things will get worse.

 

[anotherchance]

36 minutes ago, Steven W said:

I do hope so.

But let's face it, the numbers are coming down owing to lockdown.

We'll only really know if we're winning the battle when we eventually open up and judge at that point.

Question is, when will we open up and who will be brave enough to do it first. The rhetoric coming from down south suggests that Scotland might have to go first this time. If Sturgeon has it in her.

Surely we’d be able to look at the hospital/ICU stats at some point soon(ish) and see that those in the vaccinated groups make up a smaller and smaller proportion of cases - that’s the sign we’re winning the battle.

That’s what’s happening with Israel right now. Very promising stats by the looks of it.

Fear of an imaginary variant just gives an excuse for an indefinite timescale and is the worst kind of moving the goalposts.

 

 

 

[Todd_is_God]

6 minutes ago, Shadow Play said:

I’m not saying things will get worse.  That’s why is used the word “may” and not “will”.

I have a family and friends and I do worry (not overly but it is a concern) that a future mutation of COVID could prove more fatal and / or render the vaccinations less useful.

Once again, to clarify, I’m not saying things will get worse.

You can't go through life worrying about hypothetical future catastrophic events otherwise you'd never leave your hiding place under your bed.

Hancock is playing people like yourself like a fiddle with his doomsday ramblings.

[Forest_Fifer]

The thing is they can't. I had a look and same day delivery isn't available even in all of mainland Scotland for supermarkets. Of course this is probably down to cost effectiveness rather that purely logistical reasons, especially as some of the doses are being made in Stirling. But the Government have to build (and hopefully already have built) the biggest most resilient supply chain transporting, in the case of the Pfizer Vax, the most sensitive products imaginable. I would imagine that the vaccine would be flown to most of the islands rather than ferried across due to the time it takes.

If Amazon were delivering the vaccine, you'd get a single syringe rattling around inside a 1ft by 1ft by 1ft box.

[RH33]

1 minute ago, Forest_Fifer said:

3 hours ago, 101 said:

The thing is they can't. I had a look and same day delivery isn't available even in all of mainland Scotland for supermarkets. Of course this is probably down to cost effectiveness rather that purely logistical reasons, especially as some of the doses are being made in Stirling. But the Government have to build (and hopefully already have built) the biggest most resilient supply chain transporting, in the case of the Pfizer Vax, the most sensitive products imaginable. I would imagine that the vaccine would be flown to most of the islands rather than ferried across due to the time it takes.

If Amazon were delivering the vaccine, you'd get a single syringe rattling around inside a 1ft by 1ft by 1ft box.

Hermes would leave it in a neighbour (4 streets away) bin and not leave a card.

[Cyclizine]

1 minute ago, virginton said:

No, that's not the most efficient way at all, because in the intervening period an estimated 100k people have died, ICU wards are full to bursting point and the country is in version 17 of a rolling lockdown. All while there have been precisely zero medications prescribed to try and reduce the number of cases in the community who will end up requiring hospital treatment. 

Zero medications apart from a vaccine? There are no drugs that reduce the numbers requiring hospital treatment other than the vaccines. There have been lots of drugs tried, that's the whole point of a trial. What drugs are you suggesting we use in the community?

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While the medical development of treatment has been quick (and in the case of vaccines, an enormous success), it has therefore not been quick enough. An airborne pandemic does not wait for the results of controlled trials.

That's true, but a scattergun approach isn't of any help if you're causing harm rather than helping. A proper clinical study is the only way to assess this.

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Except that it's not a 'random' drug at all. It involves prescribing the same drug that is already used for months to treat Covid in hospitals, to deal with cases in the community as well. As opposed to twiddling our thumbs for three weeks until a portion of them inevitably require treatment in hospitals that are already under severe pressure.

Are you still on about dexamethasone? It categorically does not have any effect in reducing admissions from the community or severity of the disease unless you are requiring oxygen. Steroids have a myriad of other effects, not all of which are positive and can cause significant harm. It is unethical to administer drugs that have no benefit and will only cause harm. Primum non nocere if you're classically inclined.

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Of course drugs can have negative side effects. But these have to be weighed up against the wider societal costs of not applying any single medical intervention short of hospital treatment: a strategy that has utterly failed in the UK context. In the context of a pandemic overwhelming our public health system - that is causing negative impacts on almost every other category of health care - the premise that we cannot possibly risk harming Covid patients is irrational and should be binned. You act first based on the evidence and reason that you do have and then adjust best practice as trial data comes in as well. 

Now this is an ethical argument: utilitarianism versus the individual...  What do you actually think we do in hospitals? Of course we use drugs and treatments that we think might work, we then change our strategies based on our experiences and the developing science - we do exactly as your final sentence says.

[Todd_is_God]

9 minutes ago, anotherchance said:

Surely we’d be able to look at the hospital/ICU stats at some point soon(ish) and see that those in the vaccinated groups make up a smaller and smaller proportion of cases - that’s the sign we’re winning the battle.

That’s what’s happening with Israel right now. Very promising stats by the looks of it.

Fear of an imaginary variant just gives an excuse for an indefinite timescale and is the worst kind of moving the goalposts.

Absolute NAP that when this inevitably happens our media will start pointing out that younger people are making up a greater proportion of those seriously ill than previously, and people will be told we need to be cautious because "look, everyone is at risk!!1!"

[vikingTON]

19 minutes ago, Cyclizine said:

Steroids have a myriad of other effects, not all of which are positive and can cause significant harm. It is unethical to administer drugs that have no benefit and will only cause harm. Primum non nocere if you're classically inclined.

 

The medical ethics argument may apply under ordinary circumstances, it does not apply now. It is not unethical in the context of firefighting a novel virus pandemic to extend a drug that is already used in hospitals to community treatment as well, when there are no alternative treatments. Indeed, if we were dealing with a virus that killed fully half of the people that it infected then we would be shoving every single medication known to mankind at patients right now, with the 'do no harm' principle having been launched out of the window after the first week.  

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Now this is an ethical argument: utilitarianism versus the individual...  What do you actually think we do in hospitals? Of course we use drugs and treatments that we think might work, we then change our strategies based on our experiences and the developing science - we do exactly as your final sentence says.

In hospitals being the operative phrase here. There is no such attempt never mind an adjustment of strategy to treat cases outwith hospitals, which is why we are where we are right now. It is unsustainable to simply treat every phase up to that point as being beyond our control because current trial data says no/don't know. Which is why news of another potential pre-hospital treatment from Canada could be a gamechanger if rolled out without wringing our hands about unknown harms.

Edited January 24, 2021 by vikingTON

[Honest_Man#1]

21 minutes ago, Todd_is_God said:

Absolute NAP that when this inevitably happens our media will start pointing out that younger people are making up a greater proportion of those seriously ill than previously, and people will be told we need to be cautious because "look, everyone is at risk!!1!"

This is already happening. There was someone on radio Scotland this week saying exactly that, that a greater proportion of hospitalisations at present are in younger age groups than before. However there was no acknowledgement that this could be because there are less in the vaccinated groups being hospitalised which would naturally increase the percentage of younger people as part of the whole number, even if there was no/negligible increase in younger groups being hospitalised. Instead it was being played up as ‘everybody is at risk!’.

[Elixir]

2 hours ago, ICTChris said:

If vaccinations continue at their current rate, the U.K. will have vaccinated 20% of the population in ten days and 40% by the end of February.

That's fantastic news.

However, even when the vast majority of the adult population are inoculated, I think we should still stay at home under the covers, just to be safe.

You never can be too sure about anything, and I want a 100% risk free existence!

[Theroadlesstravelled]

1 hour ago, Todd_is_God said:

https://news.sky.com/story/still-a-long-long-way-until-lockdown-restrictions-can-be-lifted-matt-hancock-tells-sophy-ridge-on-sunday-12197246

There's absolutely no reason for Matt Hancock to say things like that to the press. It's pure scaremongering.

What do you want him to say about the restrictions?

[Glen Sannox]

1 hour ago, Steven W said:

I do hope so.

But let's face it, the numbers are coming down owing to lockdown.

We'll only really know if we're winning the battle when we eventually open up and judge at that point.

Question is, when will we open up and who will be brave enough to do it first. The rhetoric coming from down south suggests that Scotland might have to go first this time. If Sturgeon has it in her.

Certainly lockdown has a lot to do with it, although there is no way people are as compliant this time around. The roads are remarkably busy! With these dropping numbers combined with the vaccine, surely the SG will look to moving us back into the tiered scenario mid February. We are going to have to face up to this at some stage, it’s not going away, the vaccine and dropping numbers will allow this. 

[welshbairn]

6 minutes ago, Honest_Man#1 said:

This is already happening. There was someone on radio Scotland this week saying exactly that, that a greater proportion of hospitalisations at present are in younger age groups than before. However there was no acknowledgement that this could be because there are less in the vaccinated groups being hospitalised which would naturally increase the percentage of younger people as part of the whole number, even if there was no/negligible increase in younger groups being hospitalised. Instead it was being played up as ‘everybody is at risk!’.

It's a bit early for vaccination to be having much effect, they don't work  instantaneously.

[Todd_is_God]

Just now, Theroadlesstravelled said:

What do you want him to say about the restrictions?

If he wants to comment on them at all, then I'd prefer he stuck to what we are currently doing to work towards getting to a position to start lifting them.

I'm not at all interested in rambling nonsense about him being really worried about a hypothetical new variant.