The PPE shortage/lack of planning is a serious mistake. This is not a particualrly hi-tech product and to organise distribution is not 'herculean' if you involve the right people. To letdown the people who are literally staring the virus in the face is akin to blowing the whistle as the troops go over the top.
The goverments lockdown approach was to protect the NHS and save lives. By all accounts (even NHS) this has worked, (not more than 80% ICU beds occupied in London over Easter, and only a few (19) treated at Nightingale.
Have we saved lives. We simply don't know. Have we cost lives. We simply dont know. At this stage caveat...some frontline workers deaths could have been prevented.
If every person who needed hospitalisation received the attention, skill and access to equipment that was needed....then by definition we did everything for them.
If someone is predisposed to dying from this virus then unfortunately all we have at the moment is to hide them from the virus. No other intervention is coming anytime quickly. So unless they 'hide' for 12/18months (while waiting for those interventions) the virus is still coming for them. So eg if 1000 people are predisposed, if they are front loaded or evenly spread over a longer time, bar a few extra months life, the result is the same.
The problem with treading heavily down (via lockdowns) on new cases is two fold, 1.if it goes on for too long other problems will be a by product of the draconian measures (not just the obvious economic blow up), 2. All of us are avoiding the virus, there is plenty of evidence (war ships, cruise ships, that town in Italy) to show that large sections of the population needn't have fear of catching the virus much in the same way as they don't swerve flu year in year out. Of course we are at the same time hindering the one natural defence we can develop that doesn't require science (beyond confirming immunity is obtained)...yep the dirty 'herd' word. Ironically the old/vulnerable persons friend.
An ideal situation when relaxing some lockdown measures is to keep the NHS at about 80% capacity, as i say as long as everyone who enters hospital has uncompromised care that is the best we can do. (Plus the PPE...Of course!)
The focus on deaths is possibly a logic trap, fair enough if all the old and vulnerable want to hide away for 12/18 months (imo many i think will not find that acceptable), then yes you will save them BUT the rest of the population obviously cant carry on under the current measures for too long, korea china germany have 'great' death rates now.....the deaths are still gonna come as we have no treatment beyond hiding, plus the reduction in transmission will affect their 'herd' progress. caveat....i know anti virals, respiration etc may improve as we understand more, so some hope.
Its like the virus is in the hallway and we're all hiding behind doors of the hallway, its bouncing off those doors waiting for one to open (even a little) and bang...its back finding hosts.
FWIW if antibody testing was reliable, i'd predict 20% (if not more) off people have had the virus already, judging by how contagious it is and some of the studies (London is just like a big cruise ship) i can't see how the spread isn't massive especially if we were late on a lock down.
I'd like to point out a caveat to the 'NHS isn't overwhelmed' line of thinking. Perhaps not quite in the Lombardy way we were seeing on the news. But we had two weeks on Italy and increased surge capacity accordingly. As I think I've mentioned previously, my own trust for example has done multiple measures:
-Stopped all surgeries, other than emergency life saving surgery
-Stopped almost all elective work in other specialties as well
-Cleared out the wards in preparation
-Set aa surge plan for our intensive care, in two phases. Phase one was to double, phase two was to triple IIRC. We're currently at about 91% occupancy rate of the doubled phase one capacity. This has involved multiple measures including closing down our neurosurgery ward completely and turning it into an intensive care (bad time to get a head injury needed surgery) and redeploying nurses and doctors from other specialties who are non specialists. It has also meant that the level 1 care (which essentially is supposed to mean 1:1 nursing) no longer exists and we are often nursing at 1:2-3 patients.
-Patients who would otherwise come to the intensive care are no longer being accepted in some cases
In some other hospitals, they've been using operating theatres as a satellite intensive care units already.
So in a way, we have been overwhelmed. But if you have cancer needing an operation right now, it's growing without any prospects of surgery. If you have a funny heart rhythm or blocked arteries and were due for an elective procedure, those have been cancelled and you'd just better hope you don't have a heart attack or go into VF/VT (or if you do, someone gets to you in time) during this time. You'd better hope you don't have a head injury in West London right now, as your options are significantly reduced. If you're a 78 year old who's otherwise fit and well and come into hospital with something else and end up needing intensive care support, you may no longer be able to go and, even if you do, at least part of your care will not be at the same level it usually is.
The above isn't a criticism of the government by the way. Just some pertinent information before some, not you, get a little bit too self congratulatory and decide it was all over the top.
Despite the aforementioned 2 week warning, our deaths (even though, as far as I can tell, we're often not counting community deaths) were, as of yesterday, tracking Italy's exactly.
I agree that we are in a brick situation. I agree that we don't know how this will all play out and we are currently deciding between having your right and leg arm cut off. I actually don't think there is a right or wrong answer as such in this, just answers which are more likely to be right and those more likely to be wrong. I think the one thing though that almost anyone reasonable would agree to, other than a couple of select nutters on here, is that it can't be allowed to rip through completely unimpeded as literally no health system can cope.
