Naked Science Forum

Life Sciences => Physiology & Medicine => Topic started by: Petrochemicals on 22/12/2020 13:23:50

Title: How best to isolate Vulnerable patients from corona?
Post by: Petrochemicals on 22/12/2020 13:23:50
I disagree quite strongly with the government's lockdown response to the corona pandemic and with some (if not most) of the members on here. The virus is a novel virus so can spread very prolifically to health workers and these workers and hospital environments can pose a major threat to vulnerable patients, this contact is unavoidable. Given that essential treatments and emergency procedures in hospital have been hit by this response, what is the best means to deal with vulnerable patients?

Edit

Sorry, I've stuck it in the wrong forum
Title: Re: How best to isolate Vulnerable patients from corona?
Post by: alancalverd on 22/12/2020 13:48:52
Two approaches.

The Idiot in Chief recommends mixing them with known infectious patients in nursing homes to save paying pensions and benefits.

The medical professions use standard barrier nursing with disposable PPE obtained at several times the market price from companies owned by relatives of Conservative Members of Parliament. 

It's nothing new since the days of Semmelweiss and Lister, just deliberately mismanaged for the benefit of the unworthy.
Title: Re: How best to isolate Vulnerable patients from corona?
Post by: Bored chemist on 22/12/2020 19:31:02
If we could reliably identify vulnerable patients this thread might achieve something.
Title: Re: How best to isolate Vulnerable patients from corona?
Post by: evan_au on 22/12/2020 20:39:02
Many of the people who work in aged care have several part-time jobs, in different locations.
- So one infection in one establishment quickly spread to others
- Ensuring that people can get enough work in one location would reduce this cross-contamination

Many of the people in aged care are on casual rates, which does not pay sick leave
- So they need to go to work even if they feel a little ill (with severe consequences!)
- So providing money for them to survive self-isolation is a good idea

You can identify those exposed to coronavirus, and expect that they will get it (if they don't get an effective vaccination first)
- Treat them as if they already have it
- Organize rosters so they don't work in areas of the hospital that don't have coronavirus
- Do prospective contact tracing for them (ie "where do you live, who do you live with, where do you normally go, who do you normally interact with"). This will save time later.
- Give them the option to stay in funded accommodation close to the hospital, so they don't infect their families 

But a vaccine must be part of any solution.
Listen from 32:30    https://www.nature.com/articles/d41586-020-03594-6
Title: Re: How best to isolate Vulnerable patients from corona?
Post by: charles1948 on 22/12/2020 20:57:21
Couldn't all Covid patients be taken to special hospitals designed and equipped to care only for them.

In these hospitals, the covid patients would get the treatment they need. Without the risk of infecting non-covid patients?

Title: Re: How best to isolate Vulnerable patients from corona?
Post by: alancalverd on 22/12/2020 23:58:38
Indeed. All we need to build them is the money we have already spent and the time we do not have. Plus enough staff to run the place, and some form of treatment.
Title: Re: How best to isolate Vulnerable patients from corona?
Post by: Petrochemicals on 23/12/2020 06:04:05
Couldn't all Covid patients be taken to special hospitals designed and equipped to care only for them.

In these hospitals, the covid patients would get the treatment they need. Without the risk of infecting non-covid patients?


Indeed. All we need to build them is the money we have already spent and the time we do not have. Plus enough staff to run the place, and some form of treatment.

I believe they where called the nightingale hospitals.
Title: Re: How best to isolate Vulnerable patients from corona?
Post by: evan_au on 23/12/2020 08:06:07
Quote from: Charles1948
Couldn't all Covid patients be taken to special hospitals designed and equipped to care only for them.
If we just knew who all the people with COVID-19 were, we wouldn't be in such a mess!

With even the best tests (PCR), you show as being negative for 3 or 4 days, even though you have been infected. You will probably be sent to the wrong hospital, and cause an outbreak.
- And you will show as being positive for weeks afterwards, even though you probably aren't infectious. This ties up crucial space in the COVID hospital

If you are involved in a serious car accident, you are taken to the nearest emergency unit. Nobody knows what your COVID status is
- At least in this case, the ambulance crew could administer a rapid COVID test, and would know the results by the time they reach hospital.
- But that won't change which hospital you are taken to

Perhaps 90% of the casual contacts of an infected person won't be infected.
- So do you increase the number of people in quarantine by a factor of 10, or do you allow them to isolate at home? (with suitable checks and balances...)

People with dementia can't easily tell you that they are feeling ill. So they will probably not end up in a hospital facility, and continue to spread the virus.

Rapid testing (and frequent re-testing) is part of the solution.
...Didn't the UK start a big programme to develop rapid testing? Where is it up to?
 
Title: Re: How best to isolate Vulnerable patients from corona?
Post by: Bored chemist on 23/12/2020 15:37:08
I believe they where called the nightingale hospitals.
And, because of Tory policies over the last ten years (and more), they are staffed by trained unicorns.
Title: Re: How best to isolate Vulnerable patients from corona?
Post by: Petrochemicals on 28/12/2020 02:30:52

If you are involved in a serious car accident, you are taken to the nearest emergency unit. Nobody knows what your COVID status is
- At least in this case, the ambulance crew could administer a rapid COVID test, and would know the results by the time they reach hospital.
- But that won't change which hospital you are taken to
Perhaps better isolation procedures need to be undertaken. If this where Ebola, the country would suddenly halt, people would be self quarantining. Its not and the country has not but the social and economic damage has been greater than would have been for total arrestation of activity.

If it where ebola however what would the hospitals look like? This virus is just as lethal to a chemotherapy patient or a heart or lung patient (of which there are many) than Ebola is, and stilm quite lethal to those who are the health provision providers. It is not good enough that it has been dealt with using surgical masks and hand sanitiser.

Secondly and more widely, what should we do about the more vulnerable in a situation such as this? Novel viruses will surely happen again in coming years and I do not believe utter shut downs are something that will work, are good for the country or should be relied upon, in the long term they do alot of damage.

People who are vulnerable will have to isolate until a vaccine is found, it has made no difference doing it this way to the length of isolation. But do they have to isolate in their own homes alone? There are many hotels that could be employed as isolation areas for the vulnerable people, after a brief quarantine of 2 weeks for staff and guests at least the isolation would not be so soul destroying if there where other people also isolating from the greater populace. The same goes for carehomes. It may seem a bit weird, but I cannot think of a better answer. We have a populace that is sustained with medicine, when there is no medicine the house falls.

All of this may cost, when the time comes we will have nothing in reserve to bail ourselves out with.