UKC

Got a cough? Get a test!

New Topic
This topic has been archived, and won't accept reply postings.
 minimike 30 Dec 2021

But how? No PCRs within 200 miles of me, no home tests available nationwide and no LFTs for delivery or in various local pharmacies..

what to do? Either way, don’t tell me this isn’t affecting the headline figures..

1
 wintertree 30 Dec 2021
In reply to minimike:

LFTs are being traded for favours on the local Facebook group…. Make me an offer…. (But don’t talk Bayesian).

OP minimike 30 Dec 2021
In reply to wintertree:

I believe there is one in the post..

 Dave the Rave 30 Dec 2021
In reply to minimike:

But why are we still testing. It appears rife now, so why not assume if you have the symptoms you have covid?

Is the data of positive tests now meaningless?

Yes, collect deaths and admissions but I think time to stop LFT’s ( think of the plastic waste) and PCR’s.

If you’re well enough to work then go to work?

The country will grind to a halt due to self isolation.

31
 Ciro 30 Dec 2021
In reply to Dave the Rave:

> The country will grind to a halt due to self isolation.

Better the country grinds to a temporary economic halt than the NHS is overwhelmed, and people die in corridors while surgeries are cancelled and otherwise treatable conditions are left to deteriorate, no?

22
 Offwidth 30 Dec 2021
In reply to minimike:

Alan McNally has been pretty critical on testing in England on Twitter recently and often retweets stuff not hitting the main newspapers.

https://mobile.twitter.com/alanmcn1

2
 Dave the Rave 30 Dec 2021
In reply to Ciro:

> Better the country grinds to a temporary economic halt than the NHS is overwhelmed, and people die in corridors while surgeries are cancelled and otherwise treatable conditions are left to deteriorate, no?

The major problem that health and social care has at the minute is lack of staff due to isolation.

Hospitals are not overwhelmed. ( ours aren’t anyway, staff shortage is the main issue affecting pt care).

Now, as most admissions are the unvaxed( let’s not argue this, it’s been done to death), they will either go one way or the other. Their choice( unless unable to have it, then they should take as much care as possible).

Once the unvaxed have gone either way, then services should return to normal.

I know of quite a few staff, covid positive, sat at home, who want to come back to work. The great majority of the people they meet will be vaxed and unlikely to suffer serious harm from them.

24
OP minimike 30 Dec 2021
In reply to Dave the Rave:

That’s just an insane attitude. There are so many asymptomatic or near asymptomatic cases. Without testing it’ll spread twice as fast. 

10
 RobAJones 30 Dec 2021
In reply to Dave the Rave:

> Is the data of positive tests now meaningless?

Not if you work with or have contact with the vulnerable

> Yes, collect deaths and admissions but I think time to stop LFT’s ( think of the plastic waste) and PCR’s.

I think we still need to collect that data at least for a few more weeks 

> If you’re well enough to work then go to work?

Best case scenario I can see that as a possibility, it's the only way schools will function in a way approaching normal next term, but we need more data before that can be considered. 

> The country will grind to a halt due to self isolation.

If omicron isn't as mild as hoped there will be some sort of restrictions anyway. 

2
 Dave the Rave 30 Dec 2021
In reply to minimike:

> That’s just an insane attitude. There are so many asymptomatic or near asymptomatic cases. Without testing it’ll spread twice as fast. 

I think that the testing figures give a false sense of security. There will be hundreds of thousands of people out there not giving a flying, about being tested or being positive. 
 
I reckon that the positive cases are double what’s reported, and given the lack of responsibility of a lot of folk, then testing is now a waste of time, especially as the variant appears mild for the vaccinated and t some unvaxed.

I would now only test new admissions to hospital, and visitors from abroad to screen for new variants. 
 

Vaccinated people are dying and suffering of other ailments, due to staff shortages, due to covid, when staff with covid could be at work helping them.

Post edited at 20:08
5
 Myfyr Tomos 30 Dec 2021
In reply to minimike:

Worry not,  dear neighbours! We're riding to the rescue. 😇 Remember though, it's a loan.  https://www.bbc.co.uk/news/uk-wales-59832994

 DaveHK 30 Dec 2021
In reply to Dave the Rave:

> I know of quite a few staff, covid positive, sat at home, who want to come back to work. The great majority of the people they meet will be vaxed and unlikely to suffer serious harm from them.

> Hospitals are not overwhelmed. ( ours aren’t anyway, staff shortage is the main issue affecting pt care).

You want healthcare staff with COVID to go into work? I don't think you've really thought this through.

> Once the unvaxed have gone either way, then services should return to normal.

What about the other vulnerable people in hospitals? Those vaccinated but with suppressed immune systems etc. 

Post edited at 20:08
1
 wbo2 30 Dec 2021
In reply to Dave the Rave: that's great for you Dave but right now Ive got  a large industrial facility I work with that isn't working as they have an outbreak of Covid and can't fill safety critical roles. 

 I'm aware people just want to let rip, but even amongst vaccinated folk people get too sick to work.  Everything will grind to a halt

Post edited at 20:08
3
 Dave the Rave 30 Dec 2021
In reply to RobAJones:

Hi Rob

> Not if you work with or have contact with the vulnerable

Then let’s just test those staff?

> I think we still need to collect that data at least for a few more weeks 

> Best case scenario I can see that as a possibility, it's the only way schools will function in a way approaching normal next term, but we need more data before that can be considered. 

As above, I think the data of positive cases is well understated? What do we do? Yes, protect vulnerable staff and kids that can’t be vaxed, after that, for me the other folk have made their own choice .

> If omicron isn't as mild as hoped there will be some sort of restrictions anyway. 

At some stage, someone in government will need to make a decision for the greater good, that if you’ve not had a vax if you can then you’ve failed to take care of your own health?

6
 wintertree 30 Dec 2021
In reply to Dave the Rave: (& minimike)

> I reckon that the positive cases are double what’s reported, 

I'm gong with 3x to 4x these days; post vaccination, more are probably asymptomatic and others are more disengaged.  Certainly the gap between ONS random sampling "with Covid" and P1/P2 "new covid" data has doubled since alpha, and the gap was estimated at around 2x back then...

> I would now only test new admissions to hospital, and visitors from abroad to screen for new variants. 

Our approach to testing hasn't changed much as the situation changes massively.  

PCR testing for isolation seems a bit pointless if the ratio really is 3x to 4x, and given the delays in PCR testing; if the suspicions about a shorter generation time for Omicron pan out, PCR testing for isolation would be almost entirely pointless even without the current lags.

McNally had I think suggested on Twitter ditching PCR testing and having clinically administered LFTs which would give a good indication of infectious individuals with near-instant feedback.

If we went with McNally's approach, I'd want some of the liberated PCR capacity used to raise the statistical power of the ONS random sampling survey enabling better regional and demographic granularity and perhaps a twice-weekly cadence.  I think that would deliver a far more consistent and useful dataset than P1/P2 testing now is, and I think the surveillance is worth while for at least another year as things (hopefully!) continue to bed down.

> Vaccinated people are dying and suffering of other ailments, due to staff shortages, due to covid, when staff with covid could be at work helping them.

If we isolated staff with every disease posing a similar risk to the patients, the whole thing would fall apart; the evaluation of risk and benefit is increasingly unintegrated between Covid and other diseases now; I would rather see a pivot towards protecting those at elevated risk of viral infection regardless of the disease; particularly through FFP2/FFP3 masks, facility integrated HEPA and/or UV biocidal air handling systems etc.  Testing of staff against all relevant pathogens to prevent those presenting an elevated risk from attending at-risk patients could be another use for re-purposed PCR capacity, assuming suitable reagents can be made for each virus.  (As opposed to blanket isolation orders).

This isn't an argument to "let it rip" but to recognise the difference in how staff with Covid and staff with any other respiratory disease are treated in terms of attendance at work and the risk presented to others; as we move past the pandemic phase, the whole picture here needs a re-think.  We could do with more testing against all transmissible diseases in healthcare, better air handling to reduce the risks, and a sensitive and fine grained application of isolation across many diseases, rather than a blunt application against one.

It's all going topsy turvy.  I don't have high hopes of seeing any rational, thought out changes in the immediate term.

Post edited at 20:24
 Dave the Rave 30 Dec 2021
In reply to DaveHK:

> You want healthcare staff with COVID to go into work? I don't think you've really thought this through.

> What about the other vulnerable people in hospitals? Those vaccinated but with suppressed immune systems etc. 

Risk assess. Positive staff don’t see high risk patients, but can see low risk patients.

8
 john arran 30 Dec 2021
In reply to Dave the Rave:

> I would now only test new admissions to hospital, and visitors from abroad to screen for new variants. 

Classic case of English exceptionalism, to believe that variants could only appear in Jonny Foreigner, so there's no longer any use in testing good 'ol British folk.

10
 DaveHK 30 Dec 2021
In reply to Dave the Rave:

> Risk assess. Positive staff don’t see high risk patients, but can see low risk patients.

You are having a laugh. This is certainly the daftest idea I've heard today, probably all week.

Post edited at 20:24
2
 wintertree 30 Dec 2021
In reply to Dave the Rave:

> Risk assess. Positive staff don’t see high risk patients, but can see low risk patients.

Send them to the wards of the unvaccinated, gravely ill Covid patients?  What're they going to do, give them Covid? 

1
 Dave the Rave 30 Dec 2021
In reply to wintertree:

If you’re tending to agree with me, great.

I respect your posts no matter what.

thanks 

Dave

2
 deepsoup 30 Dec 2021
In reply to Myfyr Tomos:

> Worry not,  dear neighbours! We're riding to the rescue. 😇

Diolch yn fawr.

 RobAJones 30 Dec 2021
In reply to Dave the Rave:

> Hi Rob

> Then let’s just test those staff?

I guessing that it's those staff and people with vulnerable relatives/friends who make up the majority of tests anyway. 

> As above, I think the data of positive cases is well understated? What do we do? Yes, protect vulnerable staff and kids that can’t be vaxed, after that, for me the other folk have made their own choice .

I accept that there is a point when this will be the case, just not sure it is now. Although it might not be far off, fingers crossed. 

> At some stage, someone in government will need to make a decision for the greater good

Can you name that someone? I'm struggling ☹️

OP minimike 30 Dec 2021
In reply to Dave the Rave:

I wouldn’t disagree the stats are pretty worthless, but on an individual level, tests are still preventing some people unwittingly spreading it (to vulnerable people potentially) which affects them and healthcare.

 wintertree 30 Dec 2021
In reply to Dave the Rave:

> If you’re tending to agree with me, great.

More or less; I'm not sure PCR testing is working well either for surveillance purposes (in terms of understanding change) or for a meaningful reduction of transmission right now.

I can't see medical staff isolation orders going away until Covid has its notifiable status removed TBH - the legal/liability optics don't work out.    Yet we don't isolate staff from patients when they have other diseases that present similar risks (both low and high depending on who they see).  This is a really thorny issue and I don't really see how it all gets unpicked.

Good to see it being given an airing though!

 Dave the Rave 30 Dec 2021
In reply to minimike:

> I wouldn’t disagree the stats are pretty worthless, but on an individual level, tests are still preventing some people unwittingly spreading it (to vulnerable people potentially) which affects them and healthcare.

Hi Mike.

Should we just test care providing staff then? I’m one and have no problem with daily tests.

I

OP minimike 30 Dec 2021
In reply to Dave the Rave:

Look, I don’t know what you do for a living, but my experience of working in a hospital at the moment is it’s firefighting. There’s nowhere near the staff, equipment or bed capacity to segregate hot and cold staff and vulnerable patients. Define a vulnerable patient anyway.. that’s all of inpatient cardiology, endocrine, transplant, surgery, oncology and a good chunk of the rest I suspect. Ophthalmology and neurology is probably ok, maybe.

in the real world we need PCR tests for critical workers and everyone else can have LFTs or isolate on symptoms. Not ideal, but in the circumstances..

Edit: there seems to be a popular misconception that hospital patients have covid, cancer or in growing toenails. Shockingly it’s a bit more nuanced than that.

Post edited at 20:37
 wintertree 30 Dec 2021
In reply to minimike:

> I wouldn’t disagree the stats are pretty worthless, but on an individual level, tests are still preventing some people unwittingly spreading it (to vulnerable people potentially) which affects them and healthcare.

On the other hand, would we achieve better by:

  • Telling people they had to keep away from the vulnerable if they had coughs, sneezes, a fever, a sore throat or a snotty nose regardless of the cause?
  • Providing multi-disease asymptomatic screening on a demand-led basis for those at high risk of exposing the vulnerable?
  • Sorting out the air handling around the vulnerable?
    •  I could go off on the mother of all rants about this one and the fine line between evidence based useful guidance and buck-passing guidance with a whole chapter devote to the HSE and CIBSE, a mention of the low cost and simplicity of proper air handling systems compared to money spaffed up the wall on dodgy PPE contracts and a testing lab or two that were completely incapable of detecting Covid, and incapable of running QA.  Then I could move on to ranting about the people in large institutional organisations who represent a whole extra layer of inertia, before moving on to rant about the sub-contracted, balkanised implementation and support of facility AHUs introducing gross inefficiencies in to what should be a sodding obvious system.
      • And breath.  
  • Recognising and encouraging/mandating the use of proper PPE for staff putting the vulnerable at risk.
OP minimike 30 Dec 2021
In reply to Dave the Rave:

Probably, the only problem I have with daily tests is I can’t get any..

if you work in healthcare, I’m even more surprised by your suggestion to allow covid positive staff to care for certain patient groups (see above)

 RobAJones 30 Dec 2021
In reply to wintertree:

> More or less; I'm not sure PCR testing is working well......... for a meaningful reduction of transmission right now.

So are you saying that Mrs J is being unreasonable? I've had three negative LFT tests since being in contact with my "disease riddled family" on boxing day, but she won't let me out of "isolation" until I get a negative PCR, hopefully tomorrow. 

OP minimike 30 Dec 2021
In reply to wintertree:

Absolutely! You and who’s army?

 DaveHK 30 Dec 2021
In reply to wintertree:

> we don't isolate staff from patients when they have other diseases that present similar risks (both low and high depending on who they see).  

Have we ever had such diseases running at the kind of prevalence we currently have with COVID?

And people with things like flu do isolate after a fashion, it's just not mandated by law.

Post edited at 20:47
OP minimike 30 Dec 2021
In reply to DaveHK:

we effectively do. It’s self policed but I’d get pretty short shrift if I turned up on an oncology ward with flu or a stinking cold.. 

 wintertree 30 Dec 2021
In reply to minimike:

> Absolutely! You and who’s army?

With regards my third bullet point (Air handling): Well, quite.

I've been banging the drum over some of that stuff for a long time, and basically none of it has happened.  We had a pretty damned good late spring, summer and early autumn and as far as I can tell, sweet f**k all was done over air handling.

  • Now, this would need an army.  Too late.

With regards my first bullet point (changing testing regime): PCR testing won't stretch to the next few weeks of symptomatic members of the public; why not just tell them to isolate on symptoms, release through successive negative LFTs and reserve the PCR capacity for where it's most useful?  This'll break daily cases date, but it's probably quite broken anyway.

  • This doesn't need an army, it can happen as fast as policy can be changed and messaging can be actioned

With regards my final bullet point (PPE) - the data on properly fit-tested FFP2/FFP3 masks is clear.

  • This doesn't need an army.
  • Policy changes might make some legal eagles pucker up when considering the downgrade of PPE standards for paramedics early on in the pandemic that we've heard about from others.  I sincerely hope that is not a factor in this.
 DaveHK 30 Dec 2021
In reply to minimike:

> we effectively do. It’s self policed but I’d get pretty short shrift if I turned up on an oncology ward with flu or a stinking cold.. 

Yes, that's what I meant.

OP minimike 30 Dec 2021
In reply to DaveHK:

Yeah sorry that wasn’t aimed at you. I just hit reply to the last post!

OP minimike 30 Dec 2021
In reply to wintertree:

Agreed, except on the FFP point. Fit testing is time and resource heavy. Hard to do well, requires having various types of mask to fit all faces, needs clean shaven ideally. Without all of the above, effectiveness above surgical masks is unclear (not saying zero, but unclear). To do that properly is an army job

 wintertree 30 Dec 2021
In reply to DaveHK:

> Have we ever had such diseases running at the kind of prevalence we currently have with COVID?

I don't know.  Probably not, but I'm starting to wonder what the prevalence of some "common cold" viruses looks like at key times; surveillance data isn't that complete.

> And people with things like flu do isolate after a fashion, it's just not mandated by law.

As minimike says (below your post, above my reply) there's unofficial stuff, but that's only for symptomatic infected.  

Where parity with other diseases could break depends on how infectious a symptom free, highly immune, Covid infected person is.   It's at this point it will hopefully start behaving more like other viruses and less like a lethal pandemic, and it's at this point where screening and isolating for just one virus becomes unintegrated.

No, I don't think we're there yet, but that point lies in our future, and it's getting closer by the day.

At some point, not changing how we do things becomes the more harmful option.

I don't think we should tear up the rule book on isolation now and make drastic changes (except perhaps allowing asymptomatic, Covid infected staff to work on Covid wards where the logistics are manageable) but I would at least like to see a serious discussion about how the transition to endemic status is going to be staged, and what the triggering criteria are for each transition in control measures is, to give confidence that we're not needlessly shooting ourselves in the foot.

OP minimike 30 Dec 2021
In reply to wintertree:

Agreed, but if you look at the data for nosocomial flu in the UK it’s pretty low. Symptomatic voluntary isolation and basic HC infection control do a good job. I’m not aware of the data on asymptomatic flu, but I have the impression it’s much rarer than for covid. Also, R0(influenza) != 7

edit: ok asymptomatic flu is common it turns out. But not very transmissible.. (summary of 3 minute non systematic review)

Post edited at 21:09
 wintertree 30 Dec 2021
In reply to minimike:

>  I’m not aware of the data on asymptomatic flu, but I have the impression it’s much rarer than for covid. Also, R0(influenza) != 7

I think estimates of R0 for some of the other respiratory viruses are getting a rethink after last winter though; we saw flu effectively eliminated in the sentinel data by Covid NPIs, but other viruses held out, and as I understand it, influenza is behind a small minority of nosocomial respiratory infections.

The problem seems to me (and I'm an outsider, you're not - blunt corrections not just welcomed but expected) that the historic surveillance data isn't there to understand which viruses open the door to pneumonia a lot of the time.

This is what I mean by things becoming more unintegrated as Covid becomes more endemic - it's instrumented and measured like no other pathogen before it, and the imbalance of evidence makes it hard to understand where it really lies.

As I said before, that time is not here yet, but it's (hopefully) coming, and we should aspire to make evidence based decisions.  Very difficult with such an imbalance of evidence.

OP minimike 30 Dec 2021
In reply to wintertree:

Yeah, I suspect you’re right to some extent. There’s certainly no dashboard (!) but pneumonias will usually be identified by testing for common viruses (and bacteria). The data will be somewhere. Whether anyone has collated and analysed it is another question.. 

a side point, but if you consider how much source isolation of patients goes on in general wards you get a sense of how seriously nosocomial infection of vulnerable patients is taken. Data will be collected and in some cases reported to CQC/PHE

edit: loads of literature.. e.g. 

https://pubmed.ncbi.nlm.nih.gov/24492750/

suggests viral HAP is rare relative to bacterial.

Post edited at 21:38
 wintertree 30 Dec 2021
In reply to minimike:

> Yeah, I suspect you’re right to some extent

… and wrong to some extent.  You are far better read and experienced in this than me.  I’ll make that clear to readers.

> a side point, but if you consider how much source isolation of patients goes on in general wards you get a sense of how seriously nosocomial infection of vulnerable patients is taken.

Indeed, although my broken drum over air handling stands.  I’m well aware of the mixed heritage of the estate

> suggests viral HAP is rare relative to bacterial.

This is where I go beyond being out of my depth, but how often does a viral infection open the door for a bacterial one?  Complicated by the role of intubation as a physical route for bacterial infection.  I don’t know what the standard approach to testing is, and if viruses are tested for if bacteria are found; or if they’ll still be present by that point.  

OP minimike 30 Dec 2021
In reply to wintertree:

I’m also out of my depth here tbh. My sense is that the confounders for causation of HAP are complex (they’re hospital inpatients, often ICU) and more patient dependent than driven by superinfection over viral disease. But I’m no expert. Having said that, clearly an additional respiratory virus isn’t going to help, I just don’t know how common it actually is.

 wintertree 30 Dec 2021
In reply to minimike:

> Agreed, except on the FFP point. Fit testing is time and resource heavy. Hard to do well, requires having various types of mask to fit all faces, needs clean shaven ideally. Without all of the above, effectiveness above surgical masks is unclear (not saying zero, but unclear). To do that properly is an army job

If only we’d had a god summer to recruit and train people to do this.  Yet another item to add to the list “2021’s summer of missed opportunity”.

If we make it through the next month without a meltdown it’ll be despite the best efforts of leadership.  Its painful to think of how differently this could all be going.  

2
OP minimike 30 Dec 2021

>  I’m well aware of the mixed heritage of the estate

indeed. But the ventilation is so much better in the crumbling Victorian wings and 60s ‘temporary’ prefabs than in the hermetically sealed, recycled stale (bl)air of the PFI wings..

 Cobra_Head 30 Dec 2021
In reply to Dave the Rave:

 

> The country will grind to a halt due to self isolation.

how many dead is acceptable for you in this scenario?

Or how much strain on NHS if a reasonable figure?

6
 Dave the Rave 30 Dec 2021
In reply to john arran:

> Classic case of English exceptionalism, to believe that variants could only appear in Jonny Foreigner, so there's no longer any use in testing good 'ol British folk.

Yeah, sorry. I’m not English if that matters, but it was a typo. I meant returners from abroad not visitors.

Dave

 Dave the Rave 30 Dec 2021
In reply to minimike:

> Probably, the only problem I have with daily tests is I can’t get any..

> if you work in healthcare, I’m even more surprised by your suggestion to allow covid positive staff to care for certain patient groups (see above)

I’m not sure what the confusion is here minimike? What I think that I’ve said is that any positive tested staff could work with patients of LOW risk of infection and harm from positive staff? Correct me if I’m wrong please.  
 

2
In reply to minimike:

I'll just throw into the mix that next week we have millions of schools kids/university students going back into educational settings who all need to be testing...hope there's a few million tests down the back of a sofa somewhere

OP minimike 31 Dec 2021
In reply to Dave the Rave:

There’s no confusion. I understand exactly what you’re suggesting. I think it’s poorly conceived, and would be impractical, dangerous and irresponsible. 


The only thing that would make any sense would be positive staff looking after positive patients, but the staff are only positive for 10 days or so, leading to an unpredictable rota nightmare. Not to mention the fact that staff skills aren’t arbitrarily transferable.
 

And how are these staff supposed to get to work, enter the building, eat, etc. without spreading an incredibly infectious airborne disease in a high risk environment.

just my opinion, of course.

 DaveHK 31 Dec 2021
In reply to Dave the Rave:

> I’m not sure what the confusion is here minimike? What I think that I’ve said is that any positive tested staff could work with patients of LOW risk of infection and harm from positive staff? Correct me if I’m wrong please.  

>  

I don't think anyone is confused about what you said. I'm certainly confused about why you think it would be a good idea! So much so in fact that it's hard to imagine you're serious, however you seem to be so...

A couple of problems that spring to mind in addition minimike's observations about the difficulty of working out who is vulnerable and the difficulty of keeping positive staff away from them.

Your suggestion won't have any benefit for vulnerable patients, staff isolating will still affect them so who would benefit?

I assume coming in if positive would be optional, how many staff do you think would take up that option?

Remember in the first lockdown when people avoided going to hospital in case they got covid? People didn't get the care they needed and your strategy would bring us back to that because despite how things have improved lots of people are still afraid of covid.

First do no harm is a pretty important principle in medicine and your idea would definitely go against that.

Staff and departments are specialised. How much use would say a cardiac nurse be in some other department for 10 days? It could actually be dangerous.

We all know how stressed and pressurised NHS staff are right now. Telling someone who's been following the procedures for 18 months and doing their best to avoid catching/transmitting it that they're now going to be working with someone who has it isn't going to help with that.

People have the right to a workplace that is as safe as possible. I'd say that includes not having an official policy that purposely introduces pathogens to the workplace. Definitely some potential legal repercussions there.

I'm sure there are other reasons but that seems like plenty for now!  

Post edited at 08:01
3
 ranger*goy 31 Dec 2021
In reply to minimike:

I’ve just managed to order a box of LFTs for delivery.  

In reply to wintertree:

> If only we’d had a god summer to recruit and train people to do this.  Yet another item to add to the list “2021’s summer of missed opportunity”.

We occasionally get exposed to TB and Brucella at work, and decided to get more staff fit tested for FFP3 masks in the summer. 
 

I asked the guy doing the testing how he had coped with such a busy year - he looked a bit blank and explained that there had been a really big drop in people getting masks fitted due to decreased industrial activity. 
 

Seems like a missed opportunity somewhere.

OP minimike 31 Dec 2021
In reply to DaveHK:

Totally agree. If I was deemed to be a ‘low risk patient’ I certainly wouldn’t consent to being cared for by covid positive staff! In fact I’d jump up and discharge myself instantly if I could. I’d then be arranging a meeting with the chief exec.. in court.

1
 The Norris 31 Dec 2021
In reply to Dave the Rave:

> I’m not sure what the confusion is here minimike? What I think that I’ve said is that any positive tested staff could work with patients of LOW risk of infection and harm from positive staff? Correct me if I’m wrong please.  

>  

I work in a radiotherapy department, many of the patients are immunocompromised due to having recently had chemotherapy, or are still on chemotherapy. The ones that aren't on chemotherapy are often of an advanced age, and likely vulnerable. 

It takes many many years to train a radiographer to specialise in the profession and we don't have enough radiographers, nor radiographer students nationally.

If we let rip as per your suggestion, which will presumably result in our radiographers getting ill, who would you propose takes control of a massive high energy X Ray emmitting linear accelerator millimeters away from some blokes brainstem that could potentially leave the patient paralysed if we miss? The cleaner?

 Dave the Rave 31 Dec 2021
In reply to minimike:

Morning minimike

> There’s no confusion. I understand exactly what you’re suggesting. I think it’s poorly conceived, and would be impractical, dangerous and irresponsible. 

Perhaps, but it could be work in progress by trusts.

> The only thing that would make any sense would be positive staff looking after positive patients, but the staff are only positive for 10 days or so, leading to an unpredictable rota nightmare. Not to mention the fact that staff skills aren’t arbitrarily transferable.

>  

That is sort of what I was saying, or intending to. The Rotas are a nightmare anyway with the isolation policy. Staff are deployed to areas of need anyway without the skill set and are mentored. Once past the ten days, staff aren t required to retest for 90 days so could stay in that area?

> And how are these staff supposed to get to work, enter the building, eat, etc. without spreading an incredibly infectious airborne disease in a high risk environment.

Given the variant has apparently moved on in being less lethal, it’s less of a risk to other vaxed staff and patients.

Hospital areas can be traffic lighted with red areas for patients/ staff already with covid.

High risk patients in Green areas and potentially off site. I know this system has already been and remains in place.

> just my opinion, of course.

And mine, no offence intended.

4
OP minimike 31 Dec 2021
In reply to ranger*goy:

Awesome, me too! After 3 days of trying

thx for the heads up 

OP minimike 31 Dec 2021
In reply to The Norris:

I’m sure the medical physicists would be only too glad to step in.. 😂 

(that’s me btw)

OP minimike 31 Dec 2021
In reply to Dave the Rave:

Ok, I think we have to agree we strongly disagree at this point. it’s not personal.

OP minimike 31 Dec 2021
In reply to Bobling:

They’re behind the (s)offa’s dyke!

In reply to minimike:

I'm in Pembrokeshire and did succeed in getting a box of lateral flows delivered yesterday after them not being available the previous time I tried. A colleague had her pre booked PCR test in haverfordwest cancelled yesterday and told they were prioritising NHS and care staff. Seems sensible if they are struggling with numbers, but just to let you know we also have problems on this side of Offa's dyke.

 wbo2 31 Dec 2021
In reply to Dave the Rave: Dave .- it sounds hopelessly impractical  - more experiences we have is that the latest variant is very transmissible in a workplace, so we now have lots of people mildly sick , but sick enough we can't operate safely, and I don't see how this can function in a hospital at all. 

Sign of the times... drilling rig offshore near me, 3 chopper rides.. one for positive cases, one for close contacts and one for the unvaccinated as it can't be guaranteed they can be cared for properly on a rig. 

 girlymonkey 31 Dec 2021
In reply to minimike:

I picked some up recently from a stall in town, and then work gave me a couple of boxes too, so I have spares! 

How much you willing to pay me for them?? 😜

OP minimike 31 Dec 2021
In reply to girlymonkey:

Ha! Too slow. Market price has crashed due to 7am availability.. see above 👆 

In reply to girlymonkey:

> I picked some up recently from a stall in town, and then work gave me a couple of boxes too, so I have spares! 

Curious if your details are recorded when you picked up?

I’ve only had them from my local chemist and my name and address are taken and recorded along with the serial number of the box being given. Did wonder if this was standard practice; makes the queue at the chemist longer than it otherwise would be.

Post edited at 10:47
 girlymonkey 31 Dec 2021
In reply to Climbing Pieman:

No, they just hand them out. 

It's literally a stall in the middle of the shopping centre, they ask how many people in your household and then hand you a box per person and you walk away. 

This is in Scotland, don't know if it's different elsewhere.

 girlymonkey 31 Dec 2021
In reply to minimike:

Doh! There's my side hustle gone! Lol

In reply to girlymonkey:

Thanks (I’m in Scotland too). I should just ask my chemist next time I’m in why they record details then!

In reply to Dave the Rave:

> The country will grind to a halt due to self isolation.

It's not self isolation causing the country to grind to a halt it is Omicron Covid.  It's going to happen anyway either because of mitigation measures, or self isolation or illness.  Self-isolation is like a highly targeted lockdown, if you don't do it then it will increase the average number of people infected by each case and that will spike infections faster and make it more likely the health service can't cope and death rates go up.

 Dave the Rave 31 Dec 2021
In reply to minimike:

> Ok, I think we have to agree we strongly disagree at this point. it’s not personal.

That’s fine with me, and why discussions are interesting.

I still think it’s the way we are going though if the variants remain mild. More guidance today and reduction in time you need to self isolate here. Think it will soon become asymptomatics working as this evolves.

1
 wintertree 31 Dec 2021
In reply to Dave the Rave:

> Think it will soon become asymptomatics working as this evolves.

CDC across the pond have dropped isolation to 5 days for asymptomatically now, release without a test but with masking for another 5 days.  I don’t know if this applies to HCPs, probably not?

They’re getting a fair bit of flack for it mind you…

 The Norris 31 Dec 2021
In reply to minimike:

Hehe you joke but we have been so thin on the ground that we've had the band 8 service managers don their scrubs for the first time in 10 years to keep the service running... hilarious and terrifying at the same time! Barely know their ar*e from their elbow when looking at scans!

 deepsoup 31 Dec 2021
In reply to girlymonkey:

> How much you willing to pay me for them?? 😜

I see there was outrage on the front pages of some 'newspapers' this morning about that sort of thing going on for real. They were totally cool with Matt Hancock's mates rinsing us all for millions, but god forbid some greedy working class spiv makes a quick hundred quid!

 deepsoup 31 Dec 2021
In reply to minimike:

I so need to learn how to do that.


New Topic
This topic has been archived, and won't accept reply postings.
Loading Notifications...