Coronavirus

[gregs24]

3 hours ago, RobinB5 said:

@gregs24 you seem to know your onions. Omicron might be a a milder, albeit more transmissible, variant. Is this a natural evolution of a virus? Is this its natural end game, where it can survive most effectively? 

To some extent yes. Mutations occur frequently and naturally as a result of poor quality control in the reproductive process if you want to call it that. Each mutation changes the virus properties slightly, some significant, some insignificant. In the vast majority of cases the mutation actually renders the virus useless, but some allow the virus to take advantage of the current environment. So for example 'omicron' has a significant advantage over 'delta' in transmissibility and you can see how quickly that has meant that 'omicron' has spread. A change of virulence can also be significant where for example the virus may become far more serious and kill people really quickly, although that may be a disadvantage to virus survival because people die too quickly to pass it on. It may be that a strain will come along that is better at infecting people that have had 'beta' but not 'delta' and so may spread more effectively in a country that had a lot of 'beta' like SA but not a country that had a lot of 'delta'

In reality the changes tend to be small and in most cases confer no advantage over another strain. Certainly 'omicron' being more transmissible and potentially less virulent is a good thing as it will overwhelm most other strains. However a more virulent sub strain of 'omicron' would not be a good thing.

[gregs24]

The percentage positivity on PCR tests seems to be rising quite quickly now, especially in London. This indicates that more positive cases are being missed on daily data figures, despite greater testing numbers. This means that the positive results reported are a smaller percentage of the actual total positive cases in the country, as in cases are getting higher faster than the figures suggest. This makes complete sense where case increases are outstripping testing. It should also be noted the short period of difficulty getting LFT's and also the difficulty getting PCR tests last week for some people will impact this.

The COVID Infection Survey which tests random people (as in doesn't require symptoms or any other reason to test) will soon reflect this but currently only goes up to the 11th December. This is a very good way to determine how many cases are actually going on in the community (symptomatic or otherwise) but has a slight delay compared to daily testing data through Track and Trace.

Coronavirus (COVID-19) Infection Survey, UK - Office for National Statistics

[exeterjeep]

Omicron: Rising numbers of NHS staff off work because of Covid

The number of NHS staff off-work because of Covid is rising across England, official data shows.

Nearly 19,000 NHS staff were absent for Covid-related reasons on 19 December - up 54% on the previous week.

Health leaders say the NHS is under significant pressure, despite early studies suggesting the Omicron variant may cause a milder illness than Delta.

[Bibs]

Self-isolation and self-certification of sickness up to 28 days may be a contributing factor. 

That said, the NHS employs 1.4m people so that's still only just over 1% of staff so I'm not sure if that really is 'significant pressure' in the big scheme of things.

[Colin P]

2 hours ago, Bibs said:

so that's still only just over 1% of staff so I'm not sure if that really is 'significant pressure' in the big scheme of things.

Or looking at it another way, still only 1/3rd of "Normal" absence levels:

The number of staff days lost to Covid across the NHS in England hit 124,855 last week, a 38% jump on the 90,277 seen the week before, according to the latest “winter sitreps” data published by NHS England.

The total number of staff absences for any medical reason – such as a cold, flu or mental health problem – also increased, though less steeply, from 416,995 to 457,135, a rise of 10%.

[C8RKH]

1 hour ago, exeterjeep said:

Health leaders say the NHS is under significant pressure,

When do they ever say anything any different, regardless of the time of year, events etc?

We get bombarded with the same political BS every day re the NHS:

1. Under pressure

2. Under funded

3. Over worked

4. Under paid

 

I believe it is all a part of a co-ordinated set of messages that is meant to stoke public support for the NHS, to stoke anger at the Government, but also importantly, to hide many a true fact that the NHS is:

1. Under pressure in part, but not wholly, because it is poorly managed with not enough of some resources, too many other resources, etc. In many parts it is just grossly inefficient, and seriously addressing that would create "capacity" to relieve pressure spots.

2. Under funded as it is a largely hugely wasteful operation that needs a thorough review of the way care is managed, scheduled, delivered etc with more joined up thinking, systems and a less "fiefdom" approach where every department feels it should run how it wants to run, rather than truly embracing the best practices from the best operations.

3. Overworked in some parts, not as a whole again due to sub optimal operations, often poor leadership and management, which means it does not have the right people, in the right roles in the right places at the right time (or indeed enough of the right people, in, at etc).  There is no way that a generic statement can be made that all NHS workers are overworked (and it is often implied in the press) when you are dealing with the largest employer in the country, with the largest diversity of roles, with front office, back office, clinical roles, etc.  However, there will be specific parts in specific places were absolutely some NHS workers are over worked.

4.  Underpaid. There will be people being paid minimum wage for the types of jobs they do. Their will be some people who frankly are not paid enough for the jobs they do. And as with every organisation there will be those who are paid far too much for the jobs they do.  To use the generic statement that NHS workers are underpaid (which the press and some political parties do) is to over simplify the situation and is one of the primary ways in which these "parties" convince the public to have sympathy and solidarity with the whole NHS. 

 

As an outsider looking in. It is clear that many of the NHS' problems have been caused by, the NHS. Poor leadership. Overbearing management of the wrong things. Inefficiency. Wastefulness. Ego's that prevent change or an open mind to a better way of doing something. We could go on. however, for balance, when the NHS does it get it right, boy, the impacts and outcomes are quite literally life saving and changing.  We need to change the culture to focus on outcomes. We need to tackle the silo mentally that prevents collaboration and effective handoffs. We need to tackle the "stubborness" that allows people to run things how they want to run them, as opposed to following a proven approach that has been proven to deliver elsewhere in the NHS - "learn from the best to be the best"

These behaviours, traits, outcomes whatever, have been encouraged or compounded by every Political party using the NHS to tug on the publics heartstrings for their own ruthless pursuit of power.  Even when they use the NHS to get that power, they often then "let the NHS down" when in power. Go back and look at New Labours true treatment of the NHS when it was in power. Look at what the SNP have done to it in Scotland - yet both the SNP and Labour put their "love" and "ownership" of the NHS often at the heart of their campaigns. It often feels that the NHS is ONLY important to politicians when it can be used to win them votes, then, like a used tissue, it is discarded after use.  To be honest, the Press and their use of the NHS is no better than the politicians.

 

We need to find a way to elevate the NHS above this "political" game. To move away from political "policies" driving NHS practices over a 1, 2, 5 year term. We need a balanced, cross party approach that allows NHS policies and strategies to be driven by 10, 15 or even 20 year plans. Recruitment based on forward looking trends as to where we need what etc. Investment in the right sized facilities to give the care required to meet the needs of that particular community. We have managed to achieve this in part with NICE (though not always even  their decisions are not screamed at), that looks at things like the cost of drug therapies versus the outcomes it delivers for quality and extension of life.  Those decisions are made within a "political" framework (e.g. budgets) but the decisions are not political. We need to find a similar mechanism to manage the wider activities of the NHS.

One final thing. The original creation of NHS was a flawed exercise, and some of the problems we are dealing with today can be traced back to the legislation that created it in 1948.  GP's, under the guise of the BMA, fought hard to make sure that they maintained their private practices (yes, GP's today are usually part of private practices that contract to the NHS for the delivery of patient services - not everyone realises that). The BMA feared that doctors, if they were employed directly by the NHS, would lose income (not about patient care!). In addition, many of the bodies that ran the hospitals and clinics, the local authorities and some voluntary bodies, objected strongly that they would lose "CONTROL" over them.  Maybe this is why the NHS has been such a hot political potato, as for many, rather than ensuring the best possible care for everyone and anyone who needs it, it is seen as a way of exerting control either locally or nationally, and protecting a closed shop.

@Bibs - I hope this a balanced and debate provoking response. Please delete if not and accept my apologies.

 

[Barrykearley]

40 minutes ago, C8RKH said:

We get bombarded with the same political BS every day re the NHS:

1. Under pressure

2. Under funded

3. Over worked

4. Under paid

Hang on….. isn’t that teachers?

[C8RKH]

Lol. I'll not bite as that would be off topic . But I think it is also bin people. Local Authority Planners etc. Indeed, I think at some point every Public Sector Profession /  role seems to shout the same at some point.

[Bibs]

NHS budget this year, £176,500,000,000. 

Underfunded?!

https://www.nationalhealthexecutive.com/articles/nhs-budget-2021

£2.1bn of that on IT inc faster broadband?! Have they not heard of EE, you can get unlimited data for £50 a month!?!

[exeterjeep]

6 minutes ago, Bibs said:

£2.1bn of that on IT

Wife used to work for NHS, son still does, the amount wasted on IT is incredible. Projects started to computerise records etc, started, scrapped and again.....A bit like most government IT projects always under estimated, cost loads more and takes much longer. And may never work as intended.

[C8RKH]

@Bibs - we have a choice, we cannot continue to just blindly throw more and money at the NHS, or, we look to change, to improve, to modernise, etc.  However, we can only do that with the support of the NHS to want to change and embrace the new etc.  Unfortunately, I do not trust the NHS, or the Politicians, or the Trade Unions, to embrace the change required in the spirit required. Too many ego's and vested interests at play.

I'd happily pay more to have a better NHS, but I begrudge just throwing a bottomless pit of money at the problem.

[thebartman]

8 minutes ago, C8RKH said:

we have a choice, we cannot continue to just blindly throw more and money at the NHS

Perhaps an "honest debate" is required - starting at the basics.

1. How much is the "budget" ?

2. What are we going to treat?

Being of a certain age - I really do not fully understand IVF and gender re-assignment on the basis of free at point of service for everyone. Maybe, some activities could be conducted in-NHS on a private paid-for basis by those we have educated and trained to some of the highest levels in the world?

Just a thought ......

[Barrykearley]

21 minutes ago, thebartman said:

Being of a certain age - I really do not fully understand IVF and gender re-assignment on the basis of free at point of service for everyone.

Careful - you’ll melt the snowflakes 

[C8RKH]

@thebartman - I understand your sentiments but the two "topics" you used as an example will seriously rile some people.

Maybe the first thing is why was the NHS setup? What was the remit and purpose?

My understanding was that it was created to provide a universal comprehensive medical service and free benefits to all those in need, to help to beat want, disease, ignorance, squalor and idleness!

So maybe we should go back to basics and focus on "WHAT" needs to be included to provide a free comprehensive medical service for all those in need.  

Then we can look at the need - i.e. try to quantify the demand.

Then we look at how we best we can deliver and fulfil against the demand.

A proper, eyes wide open approach could deliver significant savings, not to reduce the cost of the NHS in whole, but to allow us to do a lot more with the budget we have. The focus should be on "outcomes" delivered AND efficiency.

[Barrykearley]

If the current lockdown rumblings continue - the I think I’m gonna ask the Doctor for a glorious pair of silicon breast implants to keep me amused following the obliteration of mankind from Covid.

[thebartman]

6 minutes ago, C8RKH said:

My understanding was that it was created to provide a universal comprehensive medical service and free benefits to all those in need, to help to beat want, disease, ignorance, squalor and idleness!

Correct

6 minutes ago, C8RKH said:

So maybe we should go back to basics and focus on "WHAT" needs to be included to provide a free comprehensive medical service for all those in need.  

A little more articulate - but ain't that wot I said? 

4 minutes ago, Barrykearley said:

If the current lockdown rumblings continue - the I think I’m gonna ask the Doctor for a glorious pair of silicon breast implants to keep me amused following the obliteration of mankind from Covid.

I've already sourced mine elsewhere - not idle, and certainly not squalid - and net zero carbon for the NHS/UK, and VAT @20%  to further contribute ....  

[C8RKH]

1 minute ago, thebartman said:

A little more articulate - but ain't that wot I said?

Lol, I guess so.  I do agree with you. 

[Barrykearley]

39 minutes ago, thebartman said:

gender re-assignment on the basis of free at point of service for everyone

Can I transfer my entitlement to @C8RKH??

[thebartman]

14 minutes ago, C8RKH said:

My understanding was that it was created to provide a universal comprehensive medical service and free benefits to all those in need, to help to beat want, disease, ignorance, squalor and idleness!

medical

/ˈmɛdɪk(ə)l/

adjective

1. relating to the science or practice of medicine.

   "a medical centre"

noun

1. an examination to assess a person's state of physical health or fitness.

   "they have medicals before they're sent overseas"

    

   Also,

   medicine

   /ˈmɛds(ə)n,ˈmɛdɪsɪn/

   noun

   noun: medicine; plural noun: medicines

   1. 1.

      the science or practice of the diagnosis, treatment, and prevention of disease (in technical use often taken to exclude surgery).

      "he made distinguished contributions to pathology and medicine"

       
   2. 2.

      a drug or other preparation for the treatment or prevention of disease.

      "give her some medicine"

       
   3. 3.

      (especially among some North American Indian peoples) a spell, charm, or fetish believed to have healing, protective, or other power.

      "Fleur was murdering him by use of bad medicine"

       

[Barrykearley]

33 minutes ago, C8RKH said:

My understanding was that it was created to provide a universal comprehensive medical service and free benefits to all those in need, to help to beat want, disease, ignorance, squalor and idleness!

Woah hang on - leave those poor unemployed job seekers alone - it’s not their fault they can’t get a job - blame the foreig……..ahh 🤪

[Barrykearley]

Anyone really wondering about some governments response to Covid - then have a squizz at this

https://www.france24.com/en/video/20211221-covid-19-in-sweden-a-vaccine-passport-on-a-microchip-implant

just getting ID cards through Parliament was a nightmare - but now it would seem many are calling for the state sponsorship of coercive behaviour that would actually be illegal and criminal in a relationship like a marriage. 

 

[PaulCP]

5 hours ago, exeterjeep said:

Wife used to work for NHS, son still does, the amount wasted on IT is incredible. Projects started to computerise records etc, started, scrapped and again.....A bit like most government IT projects always under estimated, cost loads more and takes much longer. And may never work as intended.

Don’t get me started on the quality of NHS IT “professionals”

18 years ago, when I started working for a national Ports Group, the CEO recruited a group IT manager from the NHS who he said would be ideal to specify and develop a group wide IT operating system.

The new IT manager then recruited some of his NHS mates to help.  To say that everything both he and his mates touched was a total disaster is an understatement. They couldn’t even get the security of the then current systems right.

3 years of crappy development of systems followed until the CEO finally listened and realised his big mistake. 

[oneshot]

Watching one of those medical programmes (24hrs in A&E etc) and the nurses had a problem with the computer. So they called IT and lo and behold - 3 people turned up. Two stood around watching while 1 tried to sort the problem. No wonder the IT budget is high if they send 3 people to do 1 person's job!

 

[exeterjeep]

2 hours ago, oneshot said:

3 people to do 1 person's job!

1 to do the work, 1 to complete the timesheets for charging,

and a expensive consultant to advise on how it should not be done. 

[Barrykearley]