Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: melaniejs on 18/02/2020 11:17:19
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Listener Steve wonders:
Every year the NHS go through a mid winter crisis. Is there anything scientifically proven that could reduce this annual tidal wave of woe. I'm thinking of sterile hand wash stations in schools, supermarkets and train stations for a few critical months of the year. Also monitoring the temperature of elderly people to give early intervention with antibiotics during the same period.
Is there a team of people working on ideas anywhere in the UK who can think outside the box and innovate to solve this problem?
What do you think?
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I'm pretty sure the NHS is working on it. Problem is that it is thwarted at every move by government incompetence, demographics, and customer expectations. Fiddling about with GP contracts and refusing to integrate health and social care (because acute health services can be privatised and run at a profit, but everything else is a guaranteed loss) has resulted in an almost complete absence of home care or GP appointments, so every sniffle and scratch goes straight to A&E "just in case". No integrated home care, and no funds for local authority social services, means you can't discharge anyone over 75 for fear of them either dying from untreated postoperative infection or turning up at A&E tomorrow and going through the mill again. Add a touch of bad weather, some crowded, overheated trains, and a seasonal obsession with alcohol, and a service that might just work on a sunny day, collapses.
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Every year the NHS go through a mid winter crisis. Is there anything scientifically proven that could reduce this annual tidal wave of woe.
Funding.
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Reading between the lines i very much identify with and feel your anger. Sticking to the science we have major public health initiatives. Vaccinations, mass cancer screening, age related check-ups, education and even fluoride in the water. For those few critical months of the year is there an initiative we can take to reduce infection and bed blocking. Next winter the covid 19 virus will be here, there will be no stopping it. I doubt if a vaccination will be available. Providing hand cleansing facilities at critical points such as schools and supermarkets would raise public consciousness as to the transmission of a virus. As for measuring temperature, the technology with blue tooth and data logging it would be so simple to intervene early to stop the annual migration from care home to hospital. Could a University start a study and make proposals to Government based on projected cost savings?
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It's been done a thousand times before, and AFAIK even trialled in Scotland where health and social services are better integrated. IIRC my wife was a district nurse attached to an NHS GP surgery but closely integrated with the local SS team. Great idea, as long as HM Govt ring-fences local government budget provision for social services, and imposes reasonable service standards for home delivery. Said wife later became a hospital-based discharge coordinator: same problem - it all depends on social service funding.
Unfortunately successive governments have thought it preferable to give taxpayers' money to incompetent bankers and railway "consultants", ignoring Rule 1 for survival: don't feed the sharks!
The joy of being a virus is that you can mutate and evolve at random, so this week's vaccine is for last week's epidemic. Sensibly, viruses don't kill all of their hosts (having more intelligence than humans, who happily shoot buffalo and pigeons to extinction and turn prairies into dustbowls). The way to contain a viral epidemic is, surely, home nursing. Have I mentioned that before?
One way to prevent long-distance transmission of airborne disease is to reintroduce smoking in public transport. Not sure what the figures are for trains and boats, but a non-smoking airliner only requires 3 air changes per hour, which saves a lot of fuel compared with 5 - 7 cph if smoking is permitted. AFAIK Air Malta was one of the last majors to permit smoking - worth checking their heath records! Also bring back "slam door" trains with compartments (you can't infect more than 7 others on a given journey) and fresh air ventilation. Judging from current experience on Diamond Princess, and previous fun with norovirus on ships and Legionella in hospitals, recirculating air conditioning is not merely "green" but a neat way of rebalancing the ecology by reducing the human population.