General Situation Report and Personal Analysis
We have some great news for you on production and I will fill you in tomorrow as we are having a team catch up in a few minutes...I said I'd send you an update/situation report and wanted to get it out before this evenings News Conference.
This should be taken as my personal opinion and this is explained below. It is an evidence based report however...
I’ve been working on and researching C19-2 since 22 March when I was asked to join what has evolved into the Protecting Heroes Project. I have a MSc in Health Promotion and was invited to take up a PhD at Huddersfield Uni in 2010. I’m reasonably good at data analysis and have spent several hundred hours and read several hundred pages of documents, with an academic focus, over several hundred hours.
It is always a good idea to keep in mind a quote from the Astrophysicist Richard Feynman ‘ ‘Science is a satisfactory Philosophy of Ignorance’ or in the words of one of my physiology lecturer’s ‘You don’t know what how much you don’t know, until you know how much you didn’t know’. There is never enough data for a scientist and that’s doubly the case at present.
I am not going to comment on any process just the data. I don’t see any benefit of discussing responses to the crisis. I think it’s important to understand that many of the systems and processes in place now are complex and slow at the best of times and this is far from normal times. It’s very important in my opinion that we have some sympathy for the difficulties many people are facing. Kindness, compassion, understanding and support.
We all have connections to vulnerable people and so I firmly believe that everyone working on this is trying their absolute upmost to do the right thing. The systems and processes that people are trying to follow difficult to navigate.
Below is my opinion based on data and research. The landscape changes every day and, by way of example, I have included 5 versions of PPE compliance regulations that have been updated over the last two weeks. They are all incomplete, misleading and confusing to a greater or lesser extent..
It’s quite long and unfortunately the whole team is working full tilt at the moment and so I will have to update with all the references and papers when time allows.
Most likely a three-week extension will be announced this evening and at present I think that will be extended by another 3 weeks. I think it would be sensible to plan for another six weeks.
Unfortunately, I seriously doubt we are not ‘reaching a/the peak’ in mortality rates.
The mortality peak is 7-10 days away and then there will be at least a 3 week extension from there. The peak has been moving further away from what I was hoping to see over the last week. Historically, almost all other countries have called their peaks too early. It’s natural to do this, but I’d rather take a realistic, view.
Most likely we are looking at figure this evening of 1200-1500 deaths.
I worked at the Haemophilia Unit at The Royal Free at the height of the HIV crisis and so am familiar with infection protocols. We led the way back then.
Back then the NHS had four ‘holiday days’ that each department/individual could apply where they wanted. Often one was used on the day before Easter Friday and the one after Easter Monday. So, we were expecting a drop in ‘recorded’ figures around this weekend.
It’s the same on most weekends. There is a general practice in epidemic situations were some figures are carried over to the following week and so these combination of two factors will usually result in a Monday/Tuesday’ spike.
We also still have people telling me that they have to close at 5pm and my response is ‘Tell that to the virus that is trying to kill the vulnerable person you know! No long weekend, work hours, working days or 1-2 lunch break for them.’ ‘That’s not the process we use’. ‘There’s no way to do it in less time’. Well, a lot of people I’ve worked with have found that that does not have to be the case.
Hospital/Care Home Mortalities
Three weeks ago, when official figures where quoting 5-10k mortality, I was estimating 20k mortality and this view was mirrored by epidemiologists and immunologists I was in communication with. Unfortunately, despite feeling somewhat guilty about being pessimistic, we significantly underestimated. We also discussed the impending care home problem, measurement criteria variations between countries etc, etc.
The data related to deaths outside hospital environments is measured by the ONS and a quick google will show you the problem we face there. Data release in this area has up to an 18-day lag.
It’s hard to be precise in a great deal at the moment, and believe me it is hard to write this,
But based on my analysis of the historical data (over the last few months), country-specific data, demographic analysis, infection/transmission data and recorded morbidity and mortality rates from various countries and quite a few other metrics my view is that we should prepare for the following mortality rates.
Hospital Deaths 40-50k+
Care Home Deaths 50-100K+
Let me explain.. There are approx.. 433k vulnerable people in 11k care homes and 25k ‘care environments’. At the 13/04/20 conference MH quotes the confirmed infection rate as 13.5% of care homes. This is probably data from NHS run care homes. After discussion with a range of people I estimate a current 50% infection rate.. Guidance from European Centre for Disease Control (ECDC), who’s guidance we are mostly following at present, is such that people who are below 5 on the ‘Frailty’ scale will be individually assessed as to the level of treatment that should be applied.
All hospital environments we are in contact with (at least a dozen) are reusing some or all PPE. One senior nurse is using a face shield that was made at her son’s school. There is very little PPE that should not be ‘single use’ and it will probably significantly increase infection and transmission risks to re-use. It is unclear whether it is better to re-use PPE than use none…
Wearing a mask of almost any kind will reduce the transmission of the virus from those wearing them to others. If there were enough to go around we should all be wearing one a day. I estimate we need to manufacture one thousand million surgical masks here in the UK by October this year.
If we had enough then there would, most likely, be advice to this effect. However, the WHO and most other bodies put Health care environments as the most significant multipliers of infection and so it is felt to be more advisable to have PPE there first.
David Nabbaro, WHO Director, made an announcement yesterday saying that he/WHO(?) Thought that everyone should wear a mask. I’m not sure this was wise as there is only so much to go around and this will impact supply.
The Sars, Mers and Corona type viruses are, most likely, here to stay I’m afraid and we will, hopefully, implement practices and systems that allow a return to something approaching what life was like before.
It is common for new strains of ‘infuenza-type’ viruses to arise every year and the Pharma industry is well versed in rapidly creating vaccines for the ‘Flu Jab’ that are offered before the start of flu season.
It would be reasonable to assume that this will soon become the case with the Covids, however, without jumping down that rabbit hole here, suffice to say it is pretty complex and as you’ll keep hearing for some time we just don’t have enough data to make fully-informed decisions and so we will have to find someone willing to take decisive action based on best evidenced guesses. That’s what the Chinese did. They have no problem in taking the action they believe is right and if they were wrong there is little or no comeback. This is very difficult in a democratic society but is great when you need to act decisively with haste.
The virus itself is very similar to the ‘Influenza class’ of viruses, which is a good thing in many ways. In relative terms, it is a fairly ‘moderate’ with regard to its infection and potency, but there are several other factors which amplify its effects.. Most importantly in my opinion that it remains viable for up to 72hrs on many surfaces and that there was no existing immunity to it.
It has a lipid membrane and this is also good, although it is also the reason that I believe a fundamental error in guidance is still in place, but I will come to that in a bit (C3H80-Si70 Protocol).
I’m running short of time and germicides and disinfectants is a whole other world.
I do have strong evidence though that the use of C3H80 at 70% - no lower and no higher concentration.. would be beneficial in this crisis. When placed in an atomiser and sprayed it is the most effective commonly available germicide that there is against Sars and Covid type viruses.
Commonly known as Rubbing Alcohol it is also called, Isopropyl alcohol (IPA), Isopropanol, 2-propanol, Propan-2-ol and 67-63-0. It is very important to only use at concentrations between 60 and 70% as above or below will not work.
It’s fairly safe and has a low incidence of toxicity.. Everything will have a negative reaction in a small number of people and this may effect premature babies and some others.. I am not advising you to use it.. Just stating the facts.
I’m afraid my time is up and I have to move on.
I’ll try give you an analysis news conferences including the one this evening asap.
This is just my own personal opinion and does not in anyway represent opinions or views held by anyone at Protecting Heroes.
P.s. There are also a few other measure that I think would be good to follow and I will get you that info as soon as I have time and also will update the above with links and references.
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