Sunday, 29 March 2020

COVID19 Another Question That Needs To Be Asked And Answered

We are often told to look at Italy to see where COVID19 is going in the UK. In Italy, the sharp rise in mortality appears to have been caused by the fact that the virus got into its health and social care system. That means that elderly people, and sick people, who we know, from all of the existing data, are overwhelmingly the categories that are at risk from COVID19, who are concentrated in such locations, were exposed to the virus, and once exposed, especially given inadequate isolation, and insufficient PPE for staff, meant that a large, concentrated pool of vulnerable people would succumb to it. A question that needs to be asked, in the UK, therefore, is, how many of the people that have become seriously ill, or died from COVID19, were people who were already in hospital for some other reason, and how many, likewise, were in care homes, or nursing homes? If Britain is following Italy, then we should expect that a large proportion were, in fact, already in those locations, and were infected by the virus, there, from other patients, or from staff, and visitors. That was the case, for example, with all of the deaths, and serious illness, some years ago, as a result of the spread of MRSA, and C-Dif throughout the NHS and care sector. During that period, it was also the case that nearly all of these instances of MRSA were in NHS hospitals, with virtually no instances in private hospitals. That is because, in NHS hospitals, care is founded upon industrial scale, standardised, Fordist lines, with people organised, effectively, into production lines, in large wards, whereas, in private hospitals, care is individual, with each patient provided with their own room etc. 

That would also explain why the number of deaths continues to rise geometrically, despite the government having imposed its lockdown now for a week. It is because this captive, vulnerable population, in hospitals and care homes, provides a static pool in which the virus can spread, and, given the vulnerable nature of the population, the mortality rate within it will be much higher than for the general population. That was also the case in Italy. But, this data, for the UK, is not available. Instead, we continue to have the line put out by government and others that its necessary for the whole of society to be locked down, which is destroying the economy, people's livelihoods, and will create far more ill-health and deaths, in the medium and long-term, than will COVID19.  That fact is already becoming manifest in Italy, with criminal gangs as well as desperate, hungry families forced to attack supermarkets in search of food.  But, all of the data, where it is available, continues to show that it is really only those in the at risk 20% that face significant risk from the virus. For example, Sky News reports, yesterday, that 1,028 people have died, and, 

“The vast majority of those were in England, where a further 246 deaths means a total of 935 people have died. 

NHS England said the victims there were aged between 33 and 100, and all but 13 of them had underlying health conditions. Those without underlying health conditions were aged between 63 and 99.” 

In other words, none of these deaths were of people not in the at risk 20%. So, although the government, media and others continue to push the line that everyone is vulnerable, and back that up with anecdotal stories about this or that individual who is under 40, and had no known previous, underlying conditions, the fact remains that these individuals, no matter how tragic it might be for them and their families, are a very tiny minority.  From a purely statistical perspective, which is the only rational basis upon which public policy can be formulated, so as to save the maximum number of lives, that number is insignificant. It continues to be the case that nearly everyone who dies, or becomes seriously ill, will be from the 20% of the population that is in those at risk groups, of being elderly or having underlying medical conditions. If and when full examinations of the facts, in each case, is undertaken, it will also, undoubtedly, be shown that those not in those groups that have died, will be found to have been suffering from some previously undiagnosed condition, or will have had their immune response compromised by some other factor. 

This probability that most of those dying or requiring critical care are people already in the hospital or care system, also explains why hospitals are cancelling operations and so on for people suffering with other conditions. If the majority of the spread of the virus to vulnerable people is taking place inside the hospitals and care homes themselves, then it obviously makes sense not to increase the population of such places with other patients suffering other conditions, who might then become infected themselves. That is all the more the case given the woeful inadequacy of the NHS and care system to be able to provide proper isolation for patients who are infectious, and the similarly woefully inadequate provision of PPE for staff. It then also becomes obvious that the main reason for hospitals becoming overwhelmed is that significant numbers of patients, originally admitted with other conditions, have been infected with COVID19, just as they were infected with MRSA and C-Dif, some years ago, and then require critical care, which itself is totally inadequate given ten years of austerity. 

But, this probability that most of those succumbing to COVID19 are people who were already in hospital, or in care homes, also again makes clear that the policy of closing down the economy, and trying to isolate, not the minority actually at risk, but the entire population, is totally idiotic and self-destructive. We see the pictures that have been broadcast night after night, over the last week of the huge healthcare factory in the Excel Centre, capable of processing 8,000 people on its production line. It becomes obvious what the purpose of such facilities is, because it is a way of creating large, instant isolation wards, rather like the old leper colonies, where all those with COVID19 can be corralled. Yet, even here, night after night, the pictures from the Excel centre show the same facts. The only thing missing from them is a few tumble-weed rolling across the floor, because they remain as empty as a Tory promise! 

No comments: