The paper that MedEwok shared here a while ago showing that deaths is merely the tip of the iceberg. Everyone is going “deaths deaths deaths”, because they are dramatic, but with 70% or so of symptomatic patients (not hospitalised, just symptomatic) who were in the study showing evidence of cardiac damage, there is the possibility that “just letting it rip” will set up millions in the UK alone for long term poor health outlooks.
The problem is right now we don’t know whether this evidence of cardiac damage will result in long term health problems for those who got it, or whether they will recover completely. We can roll the dice – but if in 20 years time we have, say, 1M additional people in the UK with chronic health issues as a consequence because we “let it rip”, history might be pretty unkind on those who decided to just “let it rip”.
Also, consider that if there is a possibility of cardiac complications, you can bet that medicals will start including a question “Have you ever tested positive for COVID19?” and if you answer yes, then you’re subjected to a battery of costly tests and delays in getting your medical back…
As another aside, our chief minister here got COVID back in April, and reports he still can’t taste or smell anything although his case was mild and he’s otherwise recovered. Losing your sense of taste and smell long term is a pretty quantifiable reduction in quality of life in my book.
LFHNflightstudent wrote:
Let’s say by the end of the year 2 Mio will have died.
I think that is focusing on the wrong thing. Purely from an economic point of view (leaving aside the emotional damage) someone dying isn’t so bad for the economy. Especially so if they are old, when they were probably a net cost to the economy.
Rather I think the focus should be on ‘long covid’ …. those suffering long term injuries. Some are unable to work again, some may require years of treatment, and most will not be a productive as they once were. That is a much bigger price for the economy as it effects those of productive age.
From what I read, ‘long covid’ is just a much a problem for young people as it is for old people. A young person suffering chronic fatigue, possibly for the rest of the life, is much more expensive to the economy than an 80 year old person dying. It’s certainly worth putting the economy on life support to make sure this isn’t a widespread catastrophe for the workforce, that can’t be fixed once the vaccine is available. A vaccine won’t help those with long covid.
Yes I reckon there is a fair chance that anybody who ever tests positive for CV19 may be looking at a few-k initial medical for their PPL/CPL… a nuclear perfusion scan is a likely requirement, although there may be another test which gets you off it e.g. an ECG treadmill with a clean ECG. If you can do Bruce protocol stage 3 or even 4 then you can’t be too bad.
Peter wrote:
reserve all hospital resources for CV19 patients while shafting everybody else.
I don’t know of a single hospital that did that!
What hospitals did was to ramp down elective (read: non urgent) treatments because they expected a peak in urgent patients that needed immediate care. At any given point in time – at least in Germany – all patients with the same urgency were treated equally, no matter if they had Covid, a stroke, a heart attack, a trauma, etc.
They “reserved all hospital resources for Covid patients” is just BS – at least in Germany but I doubt that NHS did it differently.
This management of elective cases is a quite normal procedure when major demand for urgent care is expected. Some hospitals in major cities even do it when large demonstrations are planned and I’m pretty sure the London hospitals did it during Olympics when many people from outside where expected. It’s part of normal capacity management when you want to make sure that nobody dies just because the bed is occupied by an avoidable case.
Unfortunately it looks like this time even in many places in Germany we will be happy that hospitals do it that way as we’ll need any available bed…
The last I saw of my brother, he was off to do a 96 hour shift on the COVID ward – all of the other doctors available either had contracted COVID or were contacts so had to isolate. He’s now been away for several days longer than that – I confess I’ve lost track of time but it’s been a seriously long shift.
We had just started doing some elective work but I can’t see it continuing. It’s one thing for somebody to choose to have a new hip if the mortality is one in several hundred, but if we had widespread COVID in the hospital it would become much higher as the combination of COVID and surgery is a bad one. When it’s not widespread you can tell who infected whom, which is not a pleasant situation.
Secondly, ways of working are now much less efficient than they used to be so work throughput is reduced. Those clinics with patients lined up in corridors and everything running late never seemed efficient or fun for patients, but they were very efficient for medical staff. Telephone or teleconferencing appointments are much slower and harder and sometimes riskier.
Thirdly, risks and benefits change so the work you would choose to do during a pandemic changes. Chemotherapy gets a whole lot riskier, for example.
We have reached a place where we can hope to do elective work safely when things are relatively calm, but the idea that we could let the elderly, sick patients take their chances and carry on with life as normal for everyone else is not realistic.
Tests purely for the purposes of enabling amateur pilots to regain their medicals will not be widely available for some time, given the huge backlog of clinical work.
Germany has private (mandatory insurance) funding of its service and as a result there is a lot of money in the system, so they have loads and loads of “kit” and surplus capacity.
The UK, like most others, runs much closer to the line. Last time, hospitals shut down whole wards in anticipation of vast numbers of CV19 patients but in most hospitals the expected “invasion” never arrived. Obviously it is a political hot potato and I know a nurse working in a large local hospital who is under strict rules to not discuss their loading, although she did say there is currently almost nobody.
Some hospitals here are creating separate sections, with its own entrance, for non CV19 work.
You will never get any pilot medical test on the NHS. It’s always a private job, and it will be a few k as a starting point. Basically the post-stent/bypass procedure. My impression is that the capacity is there, because these things are big moneymakers in the private sector. Most pilots who end up in this give up flying permanently.
Peter wrote:
Germany has private (mandatory insurance) funding of its service and as a result there is a lot of money in the system, so they have loads and loads of “kit” and surplus capacity.
It’s to a large extend not private but a public system – contributions are deducted from wages and for the “users” it feels exactly like a tax funded system. What a Germany payor does is actually not so far away from the role of a CCG in NHS (at least before 2014…).
The major difference (I believe it is an advantage but that can be debated) is that the contribution to the system is ring fenced from the very beginning and not running through the general tax budget. Therefore while it makes no difference for the paying employe, from the POV of a politician it is impossible to redirect healthcare money into other parts of the budget…
Yes that’s what I meant. I have a part family in Germany. It is a privately funded govt system.
The UK abandoned this in 1947, in the post-WW2 backlash against austerity, etc.
Peter wrote:
It is a privately funded govt system.
The entire government in Germany is a privately funded system ;-)
There are only very few countries in the world (mainly “oil countries”) where the government is not privately funded but from income from true national assets. Even China’s government is privately funded ;-)
I’m not sure “reserving hospital recourses for Coivd19” is the most appropriate term. It could just as well be described as protecting other sick people from being contaminated by covid19.
