To all fellow share owners

General Discussion Forums Life, The Universe and (almost) Everything!
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The ethical framework was developed in 2007 by the committee on Ethical Aspects of Pandemic Influenza (CEAPI). “3 Wise men” is a long established principle.

Most Trusts will have a document outlining the protocol. And around the world, other healthcare systems will also have such consideration in mind. This is not a result of political policy.

eg. https://www.dbth.nhs.uk/document/corprisk31-2/

You conflate it by alleged “starving” of funds. In a respiratory disease pandemic, there is a high risk that demand will exceed resources. You choice is either to have the appropriate amount of ventilation equipment in a hospital to deal with normal demand, or you have hundreds of pieces, that are never used; there is a cost to purchase, and an ongoing maintenance cost.

A pandemic of this sort will always overwhelm available resources, unless you take an unreasonable approach to hospital procurement. The protocol allows a doctor to act in an ethical manner when faced with a black swan-type emergency.

This approach is pretty standard in military medicine, when the MO will decide who’s worth working on, and who isn’t. Its a policy driven not by an innate expectation of survival, but how to best manage the resources available.

Triage can be used to prioritise patients by severity, but its also used to essentially ration care is so-called hard times. Triage derives from the French word “Trier”, which means to choose among several. Triage has a military origin, even though now everyone think they know how it applies in a NHS setting. There are various papers published on the ethics surrounding triage.

We know from China, by the time the patient gets to 4 weeks of treatment, their prospects are rapidly diminishing. But the prospects of someone with severe pneumonia are immeasurably improved if they are on a ventilator. Who should get the ventilator? Ideally both, but you only have one ventilator.

While I referred to blocks on exports of medicines, it should be noted there is no medicinal treatment with clear data available. In most cases, the patients suffer from viral pneumonia. Essentially, the only therapy available is ventilation; oxygen, to support the body.

The issue about experimental drugs is that they may cause more harm than good. A doctor should not do harm.

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22

Thanks for that, saz. Interesting point about the false negatives from swabs. China is beginning to find occasional cases testing positive again after being discharged from hospital after testing clear. It would be less alarming if that’s just down to the tests rather than a bug that has a dormant phase and then comes back (something in the back of my mind tells me anthrax works like that).

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There is an enormous amount of knowledge about these emerging infectious diseases; it is meaningful. The speed that COVID-19 was sequenced and a working diagnostic test developed was astonishing.

Bats have relatively depressed immune systems, so when viruses cross the species barrier, things tend to go turbo when the virus interacts with a hyperactive human immune system. People might be aware of things like cytokine storms.

Influenza has been a feature for man for 2000 years, since it crossed the species barrier. Mers crossed from bats to camels to man, and has never gone away. 60% if infections have an animal origin.

In a technical sense, the disease became a pandemic once a German worker infected a colleague back in January.

Florida is a potential problem, because the State Governor is resisting calls to publish testing rates, presumably because he is afraid of the impact of this on tourist numbers. He may face the problem they are now seeing in California, where exceptionally poor biosecurity at AFB Travis may have resulted in a community outbreak in a university town.

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Shoot me down with facts, but here’s something that crossed my mind regarding some outbreaks. Could the virus be spread by “blue ice” falling from aircraft carrying infected people, generally unknowingly? On long haul flights nearly everybody will need to use the on-board facilities and the plumbing is not always totally watertight, so?

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Anthrax goes into a spore state, in a desiccating environment. It doesn’t form spores in the body. The use of anthrax as a weapon was based on the deployment of spores which are hghly resistant to decontamination efforts (a related bacillus is commonly used as a bioindicator to demonstrate fumigation efficacy).

The test use is a RNA amplification test. Its an RNA virus, and is detectable by copying that RNA until you can detect the RNA copies by a chemical analysis (essentially). The test is specific; if you have an amplification product, you have viral RNA. Negatives are always tricky; there is a sensitivity issue (was there enough RNA in the sample that could be amplified through the normal 40 (or so) cycles that would yield an amount of RNA that can be detected by the instrument used). But sometime (often really, with an experimental assay), the test just doesn’t work (the test uses enzymes, which can be poisoned by all sorts of things present in a biological sample). To guard against that, tests have an internal standard; something else in the reagents that is also amplified. A true negative will have one product; the control. A positive will have two products. If a positive has one product, something has gone wrong, and the test needs to be repeated.

With this virus, there are cases where a patient has been infected more than once. Its not clear if there is more than one variant of the virus in circulation. Italy is developing its own diagnostic test, so perhaps they think there has been a shift. In Iran, the picture is not clear, whether Iran is under reporting cases, or what’s happening there has a horrendous mortality rate.

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Its possible, but less likely. Its blue, because the waste is in a potent disinfectant. Its frozen. When you freeze bacteria and viruses, the approach I take (because I want to minimise cell death) is to freeze with minimal water, and probably with some glycerol, to reduce formation of ice crystals, which wreck cell membranes. Its less likely that a pathogen will survive disinfection and diluted ice formation, and then its got to hit someone, or be in close proximity to someone.

In fact, an approach I took years ago to extract bacterial protein was the freeze-thaw method, because I knew it would split cells open like a cantaloupe.

More close to home, I am aware that a survey of waste water treatment works in Yorkshire showed that the foam associated with activated sludge, and which is blown about all over the sites, was loaded with Hepatitis virus. Previously, the assumption was the activated sludge process would kill off enterics. It obviously didn’t.

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Thanks Saz! :+1:

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Anthrax is bacterial in nature. Generally speaking virus do not survive outside a host environment for more than a matter of days whereas I believe bacteria can survive for months or more. Anthrax spores can survive for 48 years!!

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Apologies if I have missed the answer to these questions in previous posts:-

What is the most likely solution to stop the spread of Coronavirus?

Has the UK done all it can reasonably do to limit the spread?

Should we be proud of PHE and the actions taken to date?

30

The initial information link on Coronavirus posted early on the thread has a lot of useful, regularly updated empirical data and additional detail.
For me cumulative data is not as clear as incremental data. The incremental data for Coronavirus is very interesting and in my opinion indicates that we are already past the worst.
My interpretation of daily new case data is a peak on 4th feb.
The death toll peak gleaned from the daily death chart was 14/15 Feb.
There are some distortions which can be explained but my theory is we are already over the worst and containment has worked. Cases outside of China are the big distortion but as China already appears to have this virus under increasing control, the rest of the world will quickly follow.

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31

BT shares were a risk free investment for me. The company ran schemes where you saved money over 3 or 5 years and at the end had the option of using the money saved to buy shares at a discount from the price at the start of the scheme. On one of them I saved £3k over five years and at the end had enough to buy a very nice Audi A4 with a screen price of £10k and still have some change. Worst case was that the price had dropped by the end of the scheme and you got your money back with interest.

Rather annoying when I see the price drop on the ones I’ve got left and have thought I might just sell them. However if I put the money into savings interest rates are pitiful so the dividends give a much better return. Sell them and then the price rises and I’d be even more annoyed.

32

Unless you think the company is a dog that will never recover it is usually the wrong move to sell because the price has dropped. If it is a good company (and I am not sure about BT) it could make sense to buy more because the price has become keener.

33

Worldometers is a Shanghai-run company, that takes real data, and shoves it through an algorithm, to recreate “real data”. Its going to get found out by double counting. Don’t trust it.

Lab diagnosis is not real time. Lab testing is done in batches. The UK manages about 100 tests per day, per lab. China is reporting 5-10,000 tests per day per lab, but considered opinion is that QA is out of the window, so expect a lot of repeats.

Testing is usually on a 48-72 hour delay, depending if a monday or friday. Test criteria has changed throughout the process, within China or elsewhere. One of the frustrating things about Diamond Princess was how testing was reported. It gave a false impression, since the majority of infections started before quarantine. China counts are back up, underlying that it is impossible to determine if the crisis is peaking from a crude analysis of partial data. Similarly mortality rates; no one can calculate mortality rates, because the data is not available. In addition cause of death can cause a delay in reporting.

34

BT share ownership has been a disaster. The share has dropped from £5 around 4 years ago to its current level of £1.39.
Brokers struggle to judge this company with a mixture of buy and sell recommendations and price targets all over the shop. There are no significant short positions which is a good sign.
This is a little old but still a fair appraisal of the dividend situation going forward.
Can’t really see as there is much room for this to get any more of a hammering but I thought the same about Centrica where the dividend has been cut from 12p to 5p

35

Dadax are the owners of worldometer.
The about page on worldometer as well as the statistics themselves and quality of the information presented gives me a strong feeling that the information is probably as good as is available. The algorithms referred to are the method Worldometers use to create their counters. These are not used on the Coronavirus website. ’ The live counters show the real-time estimate as computed by our proprietary algorithm, which processes the latest data and projections provided by the most reputable organizations and statistical offices in the world.’

Having spent some time perusing this website over the last few days, I would be interested in anything that can compete with it for genuine statistics on Coronavirus, well presented and regularly updated. One can only work with the data provided and most of that inevitably originates in China.

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Not sure why this interesting discussion was ever locked. Glad to see it re-opened.

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Nothing to do with shares but as the thread has also been discussing the Coronavirus in depth here’s an interesting Q&A from the BBC news website.

Is the coronavirus worse than flu or Sars?

The answer is not as straightforward as it might seem. The virus appears to kill around 1% of people infected. This is far less than Sars (10%) Mers (34%) or Ebola (50%). However, what matters is how many people it can infect. Flu has a low death rate, but it kills hundreds of thousands of people each year because it infects so many. We still do not know if this new coronavirus is going to spread round the world.

Who is worst affected by the virus?

The old and the sick. The current fatality rate is less than 0.5% for people under the age of 50. But it rises to 8% for people in their 70s and 15% for people over 80. Meanwhile, nearly 11% of people with diseases of the heart died when infected. As did 7% of people with diabetes and 6% of people with long-term lung problems. The average for healthy people is 0.9%.

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Don’t fancy my chances if I catch it then being a 76 y.o. asthmatic! :-1:

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