Why is the ICU survival rate so low in England, Wales and Northern Ireland?

Why is the ICU survival rate for Covid-19 patients so low in England, Wales and Northern Ireland?

It’s been reported as 50%, here: https://www.theguardian.com/society/2020/mar/28/coronavirus-intensive-care-uk-patients-50-per-cent-survival-rate

Note that this article was amended on 30 March, saying that it may not be accurate, however.

Dr. David Price at the Weill Cornell Medical Center in New York City – which currently takes in almost exclusively Covid-19 patients – reported a week ago that the majority of the ICU patients there get to go home, here:
https://vimeo.com/399733860

If accurate, what does the difference reflect?

  1. The difference in socio-economics between these three countries in the UK (extensive poverty) on the one hand and NYC on the other hand?
  2. That only the most serious cases are going to the ICU over here?
  3. A higher level of specialization at that hospital in New York? (Better doctors or better practices at the hospital as it is a university hospital?)
  4. Dr. Price not having the actual numbers for his hospital?
  5. Does that hospital only treat patients from a certain segment of the population, and do they tend to be fitter and better-nourished?
  6. Something else? If so, what?

Let’s take a closer look at what the Weill Cornell Medical Center is.

Reason number 3 is my guess. Possibly in combination with reason number 5.

I looked at the insurance packages but I don’t know enough about how this works to be able to assess it.

If it’s only reason number 3 that causes the difference, then theoretically, there is room for improvement over here as the standards, theoretically, could be raised.

But we all know what’s been happening in the past 10 years of Tory reign and so there likely is no room at the moment. Or am I being too biased now?

As we just had a team of Chinese medical specialist arrive in the UK, it still looks like reason number 3 may be the main reason. That we don’t know enough andΒ  that we can still raise our standards. That would be good news, then.

https://platform.twitter.com/widgets.js

(Tweet has video.)

China also sent such teams to Italy and Iraq and maybe even more countries.

And then there is this (from 9 hours ago):
https://www.bbc.co.uk/news/av/world-us-canada-52066105/coronavirus-us-death-rates-v-china-italy-and-south-korea

“The US has seen its cases spike dramatically in recent days and these graphs show what could be in store.”

So it’s also possible that the Weill Cornell Medical Center was still in the beginning of the developments at the time, that it had not seen the worst cases yet.

And also, while the death rates in other countries have slowed down, the death rate in the US sped up. So for some reason, the death rate may have been slower there at first.

Of course, every number has to be followed by “that we know of” because some countries do a lot more testing, which means that in some countries, many mild cases go undetected and aren’t counted, which could make their death rate look higher.

Covid-19-related deaths of people who weren’t tested likely don’t count either, so countries that are finding a lot of the deceased at home may only appear to have a lower death rate.

Note that “death rate” is not the same as “ICU survival rate”.

This was followed by this, a few hours later:

https://www.theguardian.com/world/2020/mar/31/england-and-wales-coronavirus-death-toll-40-higher-than-previously-stated

One in four deaths are occurring at home, it said, and England and Wales initially had not counted those deaths.

7 days of isolation or 14 days?

That depends on the virus load you’ve been exposed to, so on the incubation period, on how soon you’d start manifesting symptoms (or maybe also on how soon symptoms would either progress or abate if you appear to have symptoms).

So for medical professionals, who get exposed to a lot of the virus, the self-isolation period is 7 days. For people who maybe were exposed to one person with mild symptoms, it’s 14 days.

Because if the latter got infected, there would be very little of the virus in their body and it would take some time for the virus to replicate into great numbers and overwhelm the body.

Does that make sense?

 

Robbery/sexual assault alert! Lockdown-related.

As my asswipe hacker(s)/stalker(s) were at it again, I left the place this evening. I mean, what on earth could I still do? Kill myself on the spot, or what?

I had intended to spend the night on a bench because I am sick of this vicious destructive shit in my own home. But I decided that the asswipe person in question is not worth getting that cold over and went on a walk instead. (That’s allowed as it counts as exercise for me and I don’t think that anyone came as close as within 5 metres of me.)

Right after that, I spotted a guy who was behaving very oddly. He was on the lookout for something. But what? He suddenly started walking, then spotted me and veered toward me to as if to check something or test something. My response? My age? My bag?

So I kept my eyes on him and fucking hell, he was following a woman, so I stayed on his tail. He kept looking behind him, too.

At some point, I saw him cross the road and I thought that that was the end of it and I slowed down, but no, he was merely taking a detour, so I sped up again.

As I came closer, I saw that there was a police car there with four officers standing around it, scratching their balls, as usual. So that was likely why the guy had crossed the road.

I kept on his tail, but by then I was too far behind and I lost both him and the woman after they went around a corner. I looked around for a while and listened for screams and the like, but saw and heard nothing that was off.

I initially thought that the danger was sexual assault but it could as well have been robbery. Or both.

Very few people around right now. Makes it easier to corner someone with nobody noticing.

I did spot a burglary on my way back (of the local LibDem office), but hey, burglary? That is 100% okay in Portsmouth. You’re a villain if you dare report a break-in.

Women, be alert! Because you have to fend for yourself. Nobody will come to your aid. Nobody will stand up for you. That’s just how it is.

With so many people losing their income, there have to be quite a few desperate people out there, but circumstances like this lockdown can also encourage more sinister elements, of course.

(I was still fuming over the hacking incident when I came home. I don’t like being messed with in my own home. It makes me feel violated – stepped on – and not safe.)

How I can help

So, a few days ago, I thought I would contact my GP office and ask if it would be helpful if I hung around to disinfect surfaces in the reception/waiting area every hour or so. So that they can concentrate a bit more on their usual tasks.

Today, I thought that maybe I should walk over to my local Aldi or some other shop and offer to help them stock shelves. (I grew up with this kind of business and I also stocked shelves as a student.)

Would that be silly or not? I have no idea.

Would that mean that I would be pushing someone else out of earnings??? If so, then I wouldn’t want to do that.

I was a little tired today, but tomorrow or the day after tomorrow, I may make some calls and simply ask. I can offer to sign a liability waiver and I can wear a mask.

Phase 2

Now we need to start thinking about the next phase (and keep a good eye on what governments are doing and stop some of them from grabbing totalitarian powers). There is a point at which extreme safety measures to shield against the virus will start to cause health problems themselves.

When people run out of food, lose jobs or even homes.

Poverty (deprivation) causes health problems too, though they are smeared out over a longer time period. There is some protection against that in the UK but not enough and not for everyone. Hard to realize.

(Not to mention that our world has to keep running.)

So it is important to find a healthy balance at some point and swing back toward the middle of the road.

Services will slowly have to start up again, in compromises, such as one day per week, maybe for one person or just a few people at a time.

Will start doing some thinking about that. Brian Earp tweeted about an article that may have some good ideas, but I haven’t read it yet as I wanted to track down some food for myself first. Succeeded! The first three tries backfired and made me feel a bit deflated, but then I ate something first, after which I headed in a different direction in town.

https://platform.twitter.com/widgets.js

Also, I just heard that some of the British changes made for people who are ill or disabled may be a very good thing to continue, but I have no good overview on what those changes are. (DWP accepting online learning and remote/working from home, which apparently it didn’t use to? Nope, was about this: https://rootedinrights.org/working-and-studying-at-home-shouldnt-be-pandemic-only-accommodations/)

 

Compromises (services in times of Covid-19)

For SOME services that are now closed, opening one day a week only and having good protocols in place on that day might be a solution.

As the virus seems to take up to 4 days to die on surfaces, the 7-day break might be enough to allow opening on one day in the week only.

Provided there is a good protocol on the day that the service is open

How can we support supermarket staff? Etc

Yesterday, I read on Twitter that a guy made someone at a Coop checkout burst into tears just because he thanked the person.

On Friday, the initial flash of emotion on the person’s face surprised me when I said “Stay well” to someone at a reception desk somewhere else. That too made me think few people had been expressing concerns for the people behind that counter.

I am often not great at it either.

Earlier this week, at Aldi, I thought I saw some tension in the person at the checkout, not surprisingly. I wish I could do something about that. When I got home, I noticed that one of the products I had bought had some substance on them and it took me a while to realize that the person at the checkout likely had been using a lot of hand sanitizer.

Although that helps, I don’t think it is enough and there is also the important task of doing things for the sole purpose of reassuring staff (making them feel protected) to help keep their stress levels down.

It kept bothering me.

I looked into what was happening in the Netherlands and read that screens had been placed around some checkout counters at DIY stores, though I haven’t been able to find any photos of it yet. Possibly, this was done to maintain the recommended distance (which protects people against this spray of tiny droplets of saliva when we speak).

(Update: When I looked into it some more just now, I saw that the Albert Heijn supermarket chain will be placing acrylic screens.)(Not sure if this is for the entire chain.)

(Update: I also found a video of a Dutch DIY store placing screens and staff saying they are really happy about that: https://www.nhnieuws.nl/nieuws/264087/spuugsschotten-moeten-caissieres-wormerveer-tegen-het-coronavirus-beschermen)

I think that placing any kind of larger screen around the people operating the checkouts might go a long way toward keeping their stress levels down. (In some supermarkets, the distance between them and the customers is smaller than at others.)

Such a screen could be acrylic (or wood or maybe even cardboard, with a small opening that might be covered with plastic, but even not covering it up but having a screen should already help protect checkout staff somewhat from the teenie tiny small droplets that fly from our mouths when we speak).

Having them wear gloves that they discard during breaks, into bins that have bags in them (liners) and then using new ones might be good but they’d go through a lot of gloves that way. But it would work as a physical reminder for them to stop them from touching their faces, which happens so automatically. (I too constantly catch myself doing things I know I shouldn’t be doing.)

Signs at counters – such as at Royal Mail – need to be at face height for standing people because we look at people first and only notice signs placed on the counter later. (But the signs on the counter may need to stay in place, too, for anyone who uses a wheelchair or mobility scooter.)

If you are working checkouts, also consider doing anything that stops your hair from falling into your face if you’d then automatically would want to push the hair out of your face – and touch your face at the same time.

And if you go to the supermarket, don’t use cash to pay if you can help it so that the cashiers don’t need to touch money.

To help protect supermarket staff. To help make them feel safer.

After customers leave the supermarket, they too should take care and for instance wash hands when they get home, but they’re already doing that, I am sure.

Regular cleaning of the self-checkout tills – to protect staff – is needed as well, but I am sure that that is already being done.

Particularly key people (management, local government) have to start doing things that will feel like total paranoia to them to protect themselves because so many people rely on them in so many ways.

Government officials and key managers may want to look into n-acetyl cysteine and assess whether it might help keep them maintain more functionality should they become infected, even though there are no data on this yet. See for example:
https://www.sciencedirect.com/science/article/abs/pii/S0882401017300505

While I am typing this, it feels like I am exaggerating, being totally over the top, but I only need to remind myself of Northern Italy to realise… no, I am not and the only thing that seems to have been able to stop (which may be merely “slow it down enough”?) the virus is to shut down all contact, the way it happened in China. (What that means for the long term is hard to tell. Delayed peaks, the virus coming back later and all that.)

Yes, I am bored as I have nothing else to do (which goes with my life in England at just about any time) and I like looking for solutions. And, also, I am furious about the weather gods having dropped the temperatures. At least it’s sunny. That’s something.

 

 

If you do catch the Covid-19 virus

For those of you who catch it and may be short of breath:

  • Drink coffee. Caffeine is a bronchodilator that works for a few hours. It can help you a little bit and make you feel more comfortable.
  • Patting your ribcage – percussion therapy – can help you loosen up mucus and get rid of it. It’s called “coupage” in the veterinary sciences. (Thanks, J. It helps a lot.)
  • Listen to your body. Sleep on the side of your body that your body tells you to sleep on, which will likely be on the right or on your belly.Β 

How do I know this?

I caught viral pneumonia in 2017, or rather, it caught me. There was a virus at the end of 2016/start of 2017 that even forced the British Queen to take it easy for a while.

I noticed at some point that the people around me seemed to be recovering whereas I was not really getting better and had very little energy. It puzzled me. I ran a fever of up to 38.6 degrees C and it was only when I read in an online newspaper that you weren’t supposed to be running a fever with this thing that I realized that I was probably “developing complications”.

One evening, I noticed that I became antsy very soon when I was on my left side and turned around to sleep on my right side. It may have been the following morning when I woke up with sharp pains in my ribcage (in my side, only on the right).

In hindsight, it was as if my body was thinking to itself and tried to say to me “No no no no! There is something going on in the right lung and I don’t want whatever it is to get the chance to end up in the left lung.” Weird? No.

24 March 2020: It’s meanwhile dawned on me that my body was probably (also) telling me that sleeping on my right side made it easier for me to get more oxygen.
Try to sleep on your belly if you find that you’re now constantly waking up. Sleeping on your belly gives your lungs more room to work. It is called “prone position”.

The brain gets lots of input from all over the body. We’re just not consciously aware of it. Sometimes, the brain tries to convey a “warning” to our consciousness via physical signals that we’re not really aware of either. I mean, what does “I became very antsy” mean? I don’t know. For whatever reason, I just really did not want to sleep on my left side. I had no idea at that point that something was going on in my right lung. (My respiratory system has always been my weak spot. I suspect I may have some scarring in that lung from previous colds or something like that. I have meanwhile learned that I always have to work at helping that lung stay clear. It is like brushing your teeth.)

Thanks to the internet, I knew what to look out for and my case proceeded by the book. There was little if anything my GP could have done unless I developed a bacterial infection on top of it, but that did not happen. (Your temperature will usually be a good guideline.)

Now, this Covid-19 thing is new and I don’t want to compare what I had to this new disease, but I did learn from what I had back then.

I felt that I should share it. This new disease is causing a lot of uncertainty and makes people feel that they have no control.

I’ve read that this is why people are stockpiling. Because it is something that they can do. Makes sense to me.

I figured that sharing what I learned in 2017 might also give some people a feeling of control.

Why did I get pneumonia?
It appears that notably or perhaps only my right lung has a tendency to fill up with goo. That makes you vulnerable to pneumonia.

(I’d had a slowly increasing lung problem for years, with my body not even always getting enough oxygen; I had noticed minor changes to the tips of my toes, was often tired and my bloodwork was very slightly off, among other things. The pneumonia helped me identify and put a lid on a few things. I found out that I am slightly allergic to wheat, for example. It irritates my throat, among other things, but it depends on the state that the wheat proteins are in. The flour on flour-dusted bread is particularly bad for me – I have to remove it – and some really yummy breads make my throat scratchy. Overall, I avoid bread. I’d started avoiding bread decades ago and ate mainly rye crackers, but circumstances can sometimes cause you to eat more wheat. Wheat allergies can also cause an asthmatic response. I also seem to respond to barley, perhaps even more. If you seem to prefer rice beers over wheat beers, that may be because you’ve subconsciously learned that wheat is not so good for you if you’re allergic to it. Budweiser, for example, has a lot less wheat in it than some other beers. Many people who have hay fever also respond to wheat etc; that response is mostly restricted to the mouth and throat area and the sinuses etc.)

Eye drops like latanoprost can also have a pronounced effect on the lungs (in spite of the fact that perhaps notably older male ophthalmologists are perfectly happy with ignoring this) and can for instance cause a chronic bad cough.

What can YOU do for your lungs?
1. Aerobic exercise. When I am extremely stationary for a few days, it throws me back because it makes it harder for my lungs to empty. (I later started taking n-acetyl cysteine, which helps me a lot because it thins the mucus and also helps calm down inflamed tissues, but if you don’t have a lung problem, don’t worry about that.)
2. Avoid foods that give you heartburn. You may not notice it at all, but it can cause a lot of irritation and slime production in your esophagus and all that can end up in your trachea. Take MaaloxPlus if you have to or to find out whether you might have this problem with acid reflux/heartburn. (It’s also sometimes called having a hole in your diaphragm or something like that, but you don’t really have a hole in your diaphragm, lol.) Exercising is also good for heartburn because it helps your digestion.
3. Take care to avoid foods that cause allergies. Those too may cause some irritation in your esophagus. They can also cause some swelling in your throat which can make it easier for bits of food and beverages to go down the wrong way, perhaps also caused by excess mucus (slippery slime).
4. Hint: If you sometimes have vague problems swallowing vitamin pills and so on, that may be because of some minor swelling (due to allergies/acid reflux) in that throat area, which could be due to such an allergy. Do you sometimes end up with weird “bumps” on the skin inside your mouth after you eat something? Well, that too could be a hint. And if it happens in your mouth, it likely also happens in your throat, right?
5. Stop smoking.

Percussion therapy (coupage)
This was a tip I got from a friend. It means clapping or patting hard on your rib cage with a cupped/flat hand to help loosen mucus. It works very well. If you do this regularly, you’ll get the hang of it and may even be able to hear whether your lungs are clear or not and you can also often feel the effect in your trachea. If you do this after you get out of the shower (the humidity of the shower is likely to help), then perhaps also blow out air very gently over a long period through pursed lips (akin to blowing long notes/tones on woodwinds), you may find yourself coughing up some goo, telling you that it’s working. Do it three times per day or so. See how it goes. You’ll learn.

Recovery during and after pneumonia
Yes, the pneumonia knocked me out for some time, as anything lung-related tends to do. (Lung-related problems can also make you very cranky because they make it hard/er for your entire body to function well.) Walking shorter to longer distances was hard for a while. When I started to feel better again and started sending myself on walks, I still would sometimes have to pause along the way. (I also used that as a gauge for how I was doing.) I’d sit down if I could or simply stopped and pretended to be busy with my phone for a little while. That was enough.

Already in an earlier stage, pneumonia means that you have to learn to pace yourself. You may have to learn to be gentle on yourself, be patient with yourself. Look after yourself well. Eat well. Nutritious food. Sleep lots, too.

Sleep whenever you feel like sleeping. Listen to your body. I sure slept a heck of a lot and kept needing to take daytime naps for a while.

Please note that I am not saying that you shouldn’t contact your GP or the like! By no means! But before your GP or another medical professional can assist you, there may already be little things that you can do for yourself and that you can continue to do afterwards, too.

For example, if you notice that you’re short of breath in the morning and usually have tea or orange juice in the morning, have coffee instead. It can help ease you into the day a little bit more gently.

These little things can really make a difference and are harmless in themselves (unless, for example, you have some kind of condition that means that you cannot sleep on your right side).

Fingers crossed. Most people who catch the virus seem to be barely affected by it.

Fingers crossed for everyone, also for everyone who does end up in intensive care, of course.

 

PS
No, my GP still doesn’t know. In case you wonder. I’ll tell them if I ever need to because of medical circumstances. I did contact them via the website when I found out that I was not supposed to be having a fever; didn’t hear back, likely because they had just been taken over by a large firm, but I was not worried and as it turned out, had no reason to worry either.

Disclaimer: I am not a medical professional.

Boris Johnson. Coronavirus. How to talk with your people.

Boris Johnson’s waffling yesterday made a lot of people – me included – angry and I am willing to bet that he did not reassure anyone. You may find some comfort in the video below instead.

Click on settings, then subtitles and then on automatic translation.

This is how his Dutch counterpart (Mark Rutte is his name) addressed the problem. (Not perfect either, but much better.) The first bit appears to be about the confusion this whole thing has sown, also in the Netherlands, where they initially may have thought that Covid-19 wasn’t necessarily going to be a problem other than that it might cause discrimination.

That was grabbed by the horns right away (by the media, including TV, and by the Health Minister) as that response was quite ugly in the Netherlands, but so far has remained entirely verbal, as far as I know. In the UK, the extent appears to have been limited, but its nature was different. (Two physical attacks occurred in London, with both victims apparently requiring surgery.)

Rutte also mentions the herd immunity concept.

He addresses money worries too and lavishes praise and gratitude.

Keep in mind that the Netherlands does not have anything anywhere near the poverty levels that the UK has.

Mark Rutte is right-wing, not a lefty.

By the way, have you noticed that the official NHS information is that none of us need to report it if we fall ill, that we do not need to get tested and that we should only contact the medical profession if our health becomes seriously compromised?

So are they using an algorithm to keep track of the infection numbers, then?

Stay at home if you have coronavirus symptoms

Stay at home if you have either:

  • a high temperature – you feel hot to touch on your chest or back
  • a new, continuous cough – this means you’ve started coughing repeatedly

Do not go to a GP surgery, pharmacy or hospital.

You do not need to contact 111 to tell them you’re staying at home.

Testing for coronavirus is not needed if you’re staying at home.

From https://www.nhs.uk/conditions/coronavirus-covid-19/

Inclusive solidarity

Wow.

Covid-19 may not only be teaching us to respect non-human animals – because if we had done that, the disease would not have crossed over to humans – it may also force inclusive solidarity on us.

Because the disease does not care whether you have 5 pounds in the bank or 50 million.

It may turn into a whopping a Zen teacher that shows us that we all have the same needs underneath our appearances and in spite of our accoutrements or lack thereof.

And it’s also accomplished a whopping temporary reduction in air pollution and emissions. There’s gotta be a lesson in that as well, not only because air pollution makes people more vulnerable to this disease.

“Save the children”

But abuse the women?

This morning, I responded to an action call from PETA regarding an organization that wants to support polar bears but does so by selling down coats with fur collars, among other things. Abuse of non-human animals lies at the basis of both the down and the fur.

‘Coyote’ to Protest Polar Bears International’s Canada Goose Coats

Just now, I received something from OpenDemocracy in my inbox, about its apparently still ongoing struggle with Save the Children concerning this:

https://www.theguardian.com/society/2018/feb/20/save-the-children-apologises-to-female-employees-over-ex-boss

https://www.opendemocracy.net/en/transformation/at-what-cost-reflection-on-crisis-at-save-children-uk/

https://www.opendemocracy.net/en/transformation/courage-of-difficult-women/

9 out of 10 believe that women are defective humans

The Guardian had an article this morning revealing that only in six countries in the world, most people consider women to be defective humans.

The UK – the world’s most openly sexist country – certainly is not among those six (and the UK is not a strong believer in human rights overall anyway).

My small home country is one of the six. So is Andorra. Even in those six countries, the situation is not entirely positive.

Globally, 9 out of 10 women and men see women as defective.
Almost a third of all women and men think that it is OK for a man to beat his wife. πŸ˜€πŸ˜”πŸ˜žπŸ˜–πŸ˜’

https://www.theguardian.com/global-development/2020/mar/05/nine-out-of-10-people-found-to-be-biased-against-women