The clapping has stopped now and people have gone back to dropping litter on the UK's beaches. What has become abundantly clear in the last few months is that consumerist medicine as promoted by the government and royal colleges is unsustainable and offers little when faced with the resurgence of infectious disease and higher mortality.
NICE dropped the referral threshold to 3% some years ago so I doubt it'll make that much difference initially. People still turn up to hospitals with advanced malignancy despite this policy. It will be interesting to review the outcomes in a few years to see how big the impact is. I suspect NG12 might turn out to be as useless as cancer screening, more of a political target than a medical one. The greatest impact is likely to be the loss of ITU capacity to provide peri-operative care to the known malignancies. This whole thing would be helped by better supply of proper PPE reducing the overall spread of COVID19 withing the healthcare system and allowing more hospital services to stay open and save lives.
The CSA is just an exam in feminist theory - power dynamics, value judgments, intersectionality, supplication, inequalities etc. It bears little relation to the science of medicine and should be scrapped.
The government not only put GPs at risk with lack of PPE but it also put patients at risk allowing doctors and surgeries to become spreading zones. It was only through the rapid and co-ordinated action of GPs that an early switch to remote consulting prevented greater tragedy and almost certainly saved thousands of lives.
What we've learned from this is that in future, government agencies and their regulators cannot be trusted. From now on we must be left to write our own policies and guidelines.
There will need to be prosecution of those who are making recommendations that are dangerous.
Sending people in and out of care homes is exactly how COVID19 gets spread around them in the first place! Even increasing contacts with regular staff is risky, social distancing is particularly important around the vulnerable.
If the government were serious about their manufactured care home crisis, thy would ensure proper PPE for front line staff, increase staff access to training, raise the status of carers and fund advice services like matrons teams.
Almost everything that comes out of NHSE is tainted with politics and should be ignored by anyone with even a hint of scientific training.
There is no evidence that hot hubs save lives.
COVID19 patients can die of 'silent hypoxia' i.e. low sats in the absence of breathlessness which typically occurs in week 2 of the illness. These means that continuous remote oximetry is more likely to be a successful strategy.
What we do know is that coronavirus spreads indoors and that a recent HSJ analysis on who is dying shows that front line anesthetists were protected by wearing PPE whereas workers in other environments seem to be at greater risk of death.
What is needed here is criminal prosecution of those who are forcing staff to put themselves at risk without adequate protection. This is a national scandal of epic proportions.
We are one of the worlds largest economies and despite off-shoring everything that moves, there are still factories and engineers in the U.K. The Tories just spent a ton of cash on ventilators of questionable use but don’t seem willing to organise some gowns and masks. This is nothing to do with logistics, it’s about money and the lack of willingness to spend what it takes to keep healthcare workers safe. It’s cheaper to let doctors and patients die. It’s a crime.
It'll probably be safer to shut down services where popper PPE cannot be provided. Without good gowns and masks, sites will just become COVID19 spreading zones and R0 will rocket to sky high rates.
This mess is the consequence of political and financial choices. It's entirely possible for factories to make gowns and we already have excellent logistics. No-one is talking about melt-blown fabric which FFP3masks are made from. This needs specialist machinery but the government chose to pay Dyson for ventilators instead of the basics needed to keep everyone safe. For some reason the media aren't covering this side of the story.
Solutions are not beyond us but the spin-doctors have been very clever at focusing all eyes on NHS clapping parades and Nightingale hospitals rather than the basics of what they need to do. The media are complicit in not asking the right questions. What a tragedy.
All community patients should now be DNAR by default.
CPR is an AGP and is not safe without high level PPE. Out of hospital resuscitation always had poor results anyway but in the case of COVID19 the hypoxia is unlikely to be reversible without intubation and ventilation. This is far too dangerous, we need to stop now or risk other people becoming infected.
Why is no-one being prosecuted? The government knew about this since Dec/Jan - they had time to scale up supply chains. Even if FFP3 is difficult, many other things are now being made like visors on 3d printers. Instead they've chucked money at Dyson whilst leaving the front line undefended.
The most important thing seems to be able to measure sats. This can be done anywhere. Buildings tend to become contaminated very easily whilst access to sufficient PPE is likely to be impossible for GPs judging by the national shortages and lacklustre efforts to date.
This is exceptionally dangerous guidance and should be binned immediately. COVID-19 kills.
Most of the governments claims are based on politics and rationing because they messed up their planning despite adequate warnings from the WHO and affected countries. A few weeks ago they let Cheltenham Festival go ahead and now people are sick. The government allowed people onto crowded tube trains whilst the police followed people around the Derbyshire dales with drones. This sort of policy only makes sense in the minds of Boris and Dominic Cummings (who are infected).
COVID-19 quickly contaminates indoor areas. It's spread is not well understood but appears to occur via the oropharynx and eyes, particularly where there is close and sustained contact, whatever the context.
In the civilised world where corronavirus is under control and not infecting healthcare staff, a proper gown, respirator, eye protection, hair covering and long gloves are regularly used.
DO NOT FOLLOW GOVERNMENT ADVICE IF YOU WISH TO LIVE AND DON'T WANT TO SPREAD COVID-19!
The GMC will need to be closed after this is over, it's their fault things have become so bad. The obsession with micromanaging front line staff and blaming them for everything that goes wrong in an under-resourced system has done nothing but harm. We are drowning in regulation but cannot even provide basic PPE for staff at risk. This must stop. Instead we need a simple list of who people are and what they do. A small number of doctors will always fall foul of the law and some will do wrong but we have courts to deal with this. Doctors must be restored to making clinical decisions about their patients. The UK almost uniquely destroyed its collegiate medical culture. We need to start listening to experts again.
Pants on fire! A paper mask, bit of plastic apron and short gloves will not protect you against COVID19. Medics are at high risk and make up 8% of infected Italian patients. They get repeated exposure and then can pass it on - potentially to hundreds of people, it's not the same as those who may have fleeting contact with the infected, the viral load is potentially much higher. NHSE are being reckless by not supplying WHO recommended kit to the front line - it's fairly easy to see what is going wrong if you look at any pictures of overseas medics then compare to us. This is a disaster - like lambs to the slaughter.
If we are now in the community spread phase, how exactly are we supposed to notify it when we haven't been issued with swabs or instructions for taking them? All this work is still going to 111 which according to Radio 4 this morning is struggling to keep up with demand.
This is totally reckless. We need to know the names of who approved this policy so they can be prosecuted. COVID-19 is the worst health threat the world has seen since the 1918 flu. If we can’t control it, it will kill 10s of thousands of U.K. patients. There is only one priority job at the moment.
The feminists lied to you. They told you could have it all, a career and a family and both would be equally fulfilling. The reality is that full time hours are a grind and children are demanding. No matter your intelligence you can’t juggle all these demands and be happy, it’s inevitable you will fail at one or another. The NHS has remorselessly exploited female agreeability and conscientiousness but the price is unsustainable and working for huge companies is likely to be far worse as they must also pay dividends. Returning to the 1950s model is far more sustainable for all in the long run.
2ww was another tiresome scam that GPs stupidly accepted as an improvement. In reality it transferred all the risk of triage and diagnosis to us in an unmitigated fashion. This lead to all sorts of potential for legal profit when attacking GPs over 'missed cancer.' The same thing happened with sepsis and we fall for it every time.
The English absolutely hate children. The UK has the lowest age of criminal responsibility in Europe. Waits for ASD/ADHD diagnosis are often over 1y. We keep them inside on PlayStations and feed them until we have high rates of childhood obesity and even diabetes. Volunteer work is impossible with endless checks and long hours for adults and a general culture of mistrust. They are divided by class and the really unfortunate ones are packed off to boarding school and then we wonder why we see so many enduring mental health problems?