CORONAVIRUS 2020: RHYTHM OF THE DEATH III

[bakabaka]

Not an ideal comparison, given that:
1) We clearly do piss away substantial amounts of scarce resources[nb]Not just cash, but actual scarce resources here-and-now.[/nb] dementia research and cancer "treatment"[nb]Which is not to say that there isn't a decent amount of - fairly cheap - cancer treatment that's highly effective.[/nb] that would be better spent on more tractable issues.[nb]Or indeed, on helping people live and die with dignity when faced with largely untractable issues.[/nb]

2) One of the major talking points of COVID-"sceptics" has been that our response to COVID-19 has massively impacted on our ability to treat people for other conditions (like easily treated cancers).

As someone who survived terminal cancer because of expensive gamma knife technology, I'd just like to say 'Fuck you!'. Life is an "untractable" issue and the history of medicine is built on pissing away resources to find cures for illnesses that would otherwise shorten it, you self-centred, right-wing imbecile. And what scarce resources other than money[nb]money scarce? If you say so...[/nb] are being wasted by trying to improve the lives of people suffering from cancers? Too many pangolin livers being used for chemo treatments? Too many kakapo brains being used on neuro-regenerative treatments?

I hope you get run over by a bus.
Really, really slowly.
And when the ambulance crew arrive that they piss away their coffee break on your flat head.

[Zetetic]

As someone who survived terminal cancer because of expensive gamma knife technology

First, congratulations.

Second, gamma knife technology isn't really expensive[nb]Particularly if we consider likely rework and complication costs from likely alternatives.[/nb] and fundamentally falls into the bucket of "fairly cheap" and "highly effective" cancer treatment that I mentioned (that mostly depends on detection at the point where surgery and radiotherapy are effective).

And what scarce resources other than money[nb]money scarce? If you say so...[/nb]

I don't think money is particularly scarce, to be clear, other than as a political choice.

Staffing - healthcare and research - however is incredibly scarce in the near-term. (Yes, fungibility is an issue here. Yes, in the long-term and a better world we can make both of these less scarce.)

I hope you get run over by a bus.

Alright.

In the interest of openness, my father and his sister died of lung cancer (in their '60s and '50s respectively). Both would have been trivially treated at relatively little cost if caught earlier, of course, but due to late diagnosis 1) inevitably died within a fairly short period following diagnosis and 2) spent much of that period in somewhat avoidable poor health[nb]You know, beyond being riddled with metastases.[/nb] and considerable distress.

I think that 2 can be somewhat laid at the door of a system that's still very poor at engaging with people about choices that best serve their interests and (incidentally) the interests of everyone else (given scarce resources). It wasn't so bad with my father, in part due to us but honestly mostly due to a more competent clinical team.

[bgmnts]

Won't lie i want to use a gamma knife.

[imitationleather]

I see you've played gamma knifey spoony before.

[phes]

Won't lie i want to use a gamma knife.

You really don't.

Get in there please
Would you like us to put some music on?
Yes my favourite song is Blue by Eiffel 65 and I have it here
You know this is quite a long treatment, right
Just put it on repeat please, my head is locked in a metal frame and I don't want to argue with...
SURE THING
You press some buttons
3 hours later you have doodled 4 pages of cocks and had a compound mental breakdown
Treatment ends

[bakabaka]

Second, gamma knife technology isn't really expensive[nb]Particularly if we consider likely rework and complication costs from likely alternatives.[/nb] and fundamentally falls into the bucket of "fairly cheap" and "highly effective" cancer treatment that I mentioned (that mostly depends on detection at the point where surgery and radiotherapy are effective).
I don't think money is particularly scarce, to be clear, other than as a political choice.

Sorry for that outburst, but a couple of years ago, when the government decided that people like me literally weren't worth saving and that we should just be given palliative care and left to die, a lot of us lobbied long and hard to get them to rethink their priorities. It meant that some diagnoses are now death sentences with no hope of escape, for purely financial reasons and their idea of "fairly cheap" is not as generous as yours. So when someone tells me that in saving my life the NHS pissed away scarce resources, I tend to react in kind. Though part of that may be the mood swings that are part of the after-effects of the treatment, obviously.

Ironically the best solution, early diagnosis, would be even more staff-intensive with everyone going for regular check-ups. But in the current climate of scepticism and mistrust of the medical world I'm not sure even that would make a huge difference. Maybe in the long run as people see that those who get check-ups and early detection tend to survive much longer/better and it would change the zeigeist, who knows?

My family also has a long, proud history of dying of cancer at 50. I fucked that up too.

[BlodwynPig]

You really don't.

Get in there please
Would you like us to put some music on?
Yes my favourite song is Blue by Eiffel 65 and I have it here
You know this is quite a long treatment, right
Just put it on repeat please, my head is locked in a metal frame and I don't want to argue with...
SURE THING
You press some buttons
3 hours later you have doodled 4 pages of cocks and had a compound mental breakdown
Treatment ends

The actual gamma knife treatment is totally painless.

[Zetetic]

Ironically the best solution, early diagnosis, would be even more staff-intensive with everyone going for regular check-ups.

Different staffing bottleneck, probably (diagnostics). Possibly a more solvable one in some ways than the enormous medical, nursing and AHP shortages.

But in the current climate of scepticism and mistrust of the medical world I'm not sure even that would make a huge difference.

While we do have an issue with lack of presentation (although I think that's more driven by perceived access issues in primary care than scepticism and mistrust), we do already have a bunch of people already presenting (often repeatedly) with vague symptoms that primary care struggles to know what to do with (in part due to poor onward access to rapid diagnostics and then treatment and possibly the challenges in getting people to make good decisions.)

Of course, post-COVID, we're going to have a huge problem with 1) backlogs in almost every part of the system (screening, diagnosis, treatment) and 2) people delaying/avoiding accessing the health service for all sorts of reasons.

[kalowski]

Won't lie i want to use a gamma knife.

[phes]

for the patient

[Fambo Number Mive]

Cameron's been busy

David Cameron lobbied the UK government to increase Greensill Capital's access to state-backed emergency Covid-19 loan schemes, months before the finance company collapsed and left the taxpayer on the hook for potential losses.

The former UK prime minister, who became an adviser to Greensill in 2018, pressed his former colleagues to give the company a bigger role in programmes designed to keep credit flowing to pandemic-hit businesses, according to people briefed on the matter in Whitehall and the City.

Public records show Greensill representatives had 10 virtual meetings between March and June last year with the two most senior officials at the Treasury as they sought access to a Bank of England loan scheme.

What the records do not show — but the FT has established from industry and Whitehall sources — is that Cameron also intervened personally on behalf of the company.

Treasury officials were reluctant to include Greensill in the Bank of England's Covid Corporate Financing Facility, even though the finance group said "concerns about their eligibility for the CCFF were misplaced or could be addressed", according to the records released under the Freedom of Information Act...

https://www.ft.com/content/6ed619c0-bb9a-44dc-a2f6-c5596a958ca8

[Blue Jam]

Not an ideal comparison, given that:
1) We clearly do piss away substantial amounts of scarce resources dementia research

Dementia researcher here. I vehemently disagree with you on this and could explain why but I'd better not.

Also words fail me.

[Zetetic]

Hope I'm full of shit, the Tory moonshot pays off, and in a few years I'll have egg on my face, you can retire, and the development, identification and care of people with dementia will no longer be an inverse-care-law dominated shitshow.

[MrMrs]

a what

[Drygate]

Yeah, imagine if Cummings legacy was delivering moonshot and saving us from covid!

With more stuff opening up in April, do you think we should tell all over 60s or at risk people they have to follow the current rules until they've had a second jab (not switch to the new April rules)?

I'm not going full Barrington but it would undoubtedly save lives.

Seeing as we're opening up more any way in April, why not try saving some more lives by telling the people most likely to die to take it easy for a bit longer?

[Shoulders?-Stomach!]

They'll be the ones strutting around thinking they're indestructible.

Anyway, more good news on hospitalisations and deaths reducing. I think cases are still net down this week vs last week too.

[Drygate]

And then if they start hitting the hospitals we'll have to lockdown again.

[Shoulders?-Stomach!]

Big rise in cases today vs same time last week. It's an outlier so far so going to be watching more carefully next few days.

[Alberon]

Hopefully we're approaching the point where a spike in cases doesn't lead to one in hospitalisations and then deaths.

[BlodwynPig]

Hopefully we're approaching the point where a spike in cases doesn't lead to one in hospitalisations and then deaths.

Global trends seems to suggest an uptick in cases more recently followed by again an uptick in deaths.

Can tell you that < LOD in the shit apart from two areas in England.

[Shoulders?-Stomach!]

Global trends seems to suggest an uptick in cases more recently followed by again an uptick in deaths.

Can tell you that < LOD in the shit apart from two areas in England.

Not sure what the bottom bit means outside of it referring to sewage samples.

Global trends remain difficult to compare to the UK as very few other countries have vaccinated 44% of the population. You would like to think that will cap deaths to a low level, but I am rather hoping they get the 2nd jabs to as many criticals as possible in the next few weeks though.

Looks like the weather's picking up next week and that all-important VITAMIN D is going to be entering our pallid skinwraiths, which will help too.

[BlodwynPig]

Below limit of detection, e.g. not enough virus to be detected from the sample within a given confidence.

[BlodwynPig]

Had a decent convo about convergent evolution (Nature published an article that the variants are showing signs of convergent evolution). An epidemiologist who works with me reminded me that the 'optimum' - i.e. the convergent variant - most likely won't be as dangerous as the original. We then got into a whole discussion about virus game theory and liminal spaces.

[king_tubby]

Below limit of detection, e.g. not enough virus to be detected from the sample within a given confidence.

This is good?

[jobotic]

Sounds good. But why would that be? Vaccine doesn't reduce transmition that much does it?

[BlodwynPig]

This is good?

Yes. Not much virus being excreted by the population in comparison to high prevalence period where concentrations were 1e4 - 1e6 gc/l

[BlodwynPig]

Sounds good. But why would that be? Vaccine doesn't reduce transmition that much does it?

Look at the REACT papers - lockdown seems to be the main driver this time.
https://www.imperial.ac.uk/people/s.riley/publications.html

[king_tubby]

Yes. Not much virus being excreted by the population in comparison to high prevalence period where concentrations were 1e4 - 1e6 gc/l

Thank you for your service, sir.

[olliebean]

The BBC seems to be reporting that cases are "levelling off," which sounds quite positive until you realise that before they started levelling off they were falling.

And when a drop in cases has levelled off is of course just the right time for a relaxation of restrictions.

[Old Thrashbarg]

Had a decent convo about convergent evolution (Nature published an article that the variants are showing signs of convergent evolution). An epidemiologist who works with me reminded me that the 'optimum' - i.e. the convergent variant - most likely won't be as dangerous as the original. We then got into a whole discussion about virus game theory and liminal spaces.

Which makes sense, because the aim (for want of a better word) for any virus is to survive/spread. And if it keeps killing off its host in such great numbers and at such speed it will soon run out of potential hosts. So the variants that keep their host alive to allow them to spread to more hosts will likely become the dominant forms of the virus.