So outbreaks are only in care homes and hospitals. What am I missing?

[mayoral]

In the governments press conference yesterday they said infection rates remain high because of outbreaks in two places: care homes and hospitals. They said transmission within the community was small and well below R1.

So why can't we contain care homes and hospitals and get on with our lives now??

[ErrolTheDragon]

The other thing the OP seems to be missing is if the rest of us revert to normal and 'get on with our lives now' then the R value in the community will inevitably rise from the suppressed value achieved by lockdown, above one, and then we're back into exponential growth of cases and deaths again. Infection outside of hospitals and care homes hasn't been eliminated.

Whatever happens next can't simply be going back to doing things as usual.

[Mummyoflittledragon]

Yeh and my dh has a masters in econometrics. Funnily enough he doesn’t agree.

Do you want me to set the two of you a test to see who’s right?

I have a better idea. Let’s put all the hospital patients and care home residents inside prisons and let the inmates care for them. 🤦‍♀️

Ink - here’s your order....
Popcorn 🍿
Diet Coke 🥤

[iamapixie]

fascinated. So true. It is impossible to discuss anything when things people disagree with are taken as a personal insult.

[Myfriendanxiety]

@midgebabe my DH works in finance for the NHS-There was always plenty of money for PPE, but poor negotiation and management meant it couldn’t be sourced despite the cash being there to pay for it.

As a country we haven’t focused enough on investment in UK manufacturing and have been too reliant on other counties shipping to us. Now we are paying the price as we don’t have the facilities to produce enough of our own PPE or tests.

[GrapefruitsAreNotTheOnlyFruit]

To stop in spreading in care homes and hospitals so quickly don't we need to to actually test and isolate? So homes and hospitals dedicated to those with covid and we could use the Nightingales that we have just such.

Oh and of course we would need constant testing and proper PPE for staff so that it doesn't spread into the community.

Otherwise how will we ever restart routine medical care? As soon as someone goes into hospital for treatment they will be at risk of catching covid.

[SylvanianFrenemies]

Citing your qualifications is a bit desperate. It's like saying "I need to evidence that I must be right, because I can't do it with actual discussion points or ideas".

People aren't saying "do nothing". They are saying "do something workable". Generally speaking, that doesn't involve imprisoning innocent care workers, nurses and doctors, and shutting hospitals.

Lockdown is hard, with massive economic ramifications. Do you think it is possible to have a global pandemic without economic fallout? We would have been best to follow a decisive course of full early lockdown and rigorous tracing. Too late (thanks BJ & pals..). So now we are paying for it. And will continue to pay for it.

I'm not on furlough. I'm working as a clinician in the NHS. But I can see that furlough has saved jobs, lives, and (perhaps most important to you) economic activity.

[eaglejulesk]

I did see a care home in the Isle of Wight did exactly that. The staff left their families and moved in

This happened in a place in NZ too - the staff chose to do so

[Choccyp1g]

EricaNernie Fri 08-May-20 08:26:12
is there a problem in prisons? or do we not care enough to be told?

There most certainly is:

www.southwalesargus.co.uk/news/18400563.much-loved-prison-officer-hmp-usk-dies-coronavirus/

[fromlittleacorns]

There is some discussion on twitter about this possibility. I wondered the same thing on another thread - taxis for all care and hospital workers rather then public transport, daily testing with same day results ( though i read today that in some cases results arent coming backfor 10 days - if true that suggestion is obviously a non starter!), daily temperature screening (i know that has limitations!), ppe for all care workers and nhs workers, contract tracing focused on these sectors.

Phenomenally Phenomenally expensive, complicated to administer and not at all 100% effective. On the other hand lockdown is expensive and large scale unemployment is not a good prospect and can have long-term economic and health consequences. Educational attainment gap will have long term consequences and Some pp on mn (As well as me, i mean!) have expressed concerns about vulnerable dc currently living in abusive homes. So i guess it makes sense to have discussions about possible ways out. Most wont be runners, but i think its good to discuss them. This thread has pointed out some of the many problems with this idea!

[CherryPavlova]

There are a few reasons that the outbreak seems confined to care homes and hospitals. Mainly it’s massaging figures.

There is a statutory requirement to notify deaths in care homes and hospices. Has been for years. They weren’t being counted and certainly weren’t attributed to Covid19 until after 17th April. The reporting publicly changed after then to include the care home deaths likely to be Covid19 related. You can see the leap in figures and change to the trajectory.
NHS hospitals report via a different system.
There is no notification or way of counting community deaths. GPs certifying do not need to notify anyone.

Testing is inadequate so many Covid19 deaths are not reported as such.

Many deaths in the community are likely to be Covid related but not identified as such as they occur in people with co-morbidities that are given as the cause of death.

There is idiosyncratic variation in the decision to transfer people, particularly older people with Covid19 for hospital care at an early stage of disease. That means more will have died in the community - unless you are a prime minister. One of the reasons we have excess capacity is because people have not been offered hospital care based on a DNACPR which should only apply if they actually need resuscitation and not be is d as a care limiter unless there is also a ReSPECT form completed and agreed decision made about the ceiling of care.

People removed from society are lowering the risk of contracting the disease themselves and people taking the lockdown seriously are reducing the risk to themselves and others.

Care homes are generally doing a fantastic job in continuing to provide care but the staff are human. They need time away, they need their families and rest.

[Lemonblast]

Blimey. Seems like anyone can get themselves a Masters these days

To expand on some of the questions about why Covid spreads so quickly in Care Homes. It’s a highly contagious virus. It lives on surfaces. Residents in care homes will often wander because of their dementia. Social distancing is often impossible. Hand washing cannot be enforced without physically manhandling (aka assaulting) patients. Many residents have underlying respiratory conditions which cause them to cough. Many residents are doubly incontinent which requires nurses and carers to be in the closest physical proximity imaginable.

I think the government is now using the care home spread ‘figures’ to appease the business community. The same business community which resisted moves to shut down businesses until they were absolutely forced to do so.
But yeah OP. Definitely lock down hospitals and care homes now to mitigate the disaster that had been created by other sectors.
When are you starting your PHd?

[fascinated]

I think the OP has highlighted a big problem that we have in the UK - the inability of “highly educated” people to recognise that their (No, our - I include myself in that category) type of “intelligence” and “skills” are the only ones worth valuing.....

I used to be so arrogant. A real intellectual snob. Until I had children, and elderly parents to care for. A few health issues. Stopped just commuting from a dormitory town and started to live with the people in the town, interacting in shops and community groups. I realised that a lot of the people without degrees or fancy jobs and job titles had fantastic practical skills and common sense, not to mention determination, optimism, kindness, humour and many other fab qualities to boot. I ate lots of humble pie. And yet those people are rarely listened to - by governments/councils/civil servants/planners etc - when it comes to trying to solve the problems we face as a society. I think the handling of this crisis shows that very clearly.

[RedLentilYellowLentil]

Fuck sake. So there's NOTHING we can do to contain the outbreaks? Nothing? Just mock me? And lockdown the entire country instead. Well done everyone

Test and trace, OP, test and trace. The government totally dropped the ball on both and has no idea what the community transmission rate or patterns are.

And as for all their BS about how the R0 doesn't matter unless the prevalence is high, well, you would need to know that the prevalence is low for that to be reassuring!

[oiboi]

Hospitals and care homes are where people are mixing and having prolonged contact. We have reduced that in most other areas by lockdown.

Would you agree to stay in a hotel away from your family and kids? Who'd do the childcare? People would leave in droves. A number of staff in our NHS staff have already left due to new terms and conditions and anxiety.

[1forsorrow]

The WHO was quite clear from the beginning that this was a big problem. People and companys chose to not listen but wait for the government. Because apparantly the UK is so much wiser than the WHO. So it is our fault that we listened to the govt when they said it was fine to shake hands, fine to go to Cheltenham/Crufts/Marathons/Concerts/ Football etc. Should we listen to the same govt now? Are they any more reliable now than they were in March. Shall we all just make our own decisions because if that is OK I'll go and get the car and drive 200 miles to see my GC.

[AlohaMolly]

This situation isn’t caused by individual people or by poorly paid, undervalued care home staff, this situation is caused by a shit show of a government who couldn’t give two fucks about the elderly, the vulnerable, the poor and BAME citizens, all of whom this virus disproportions effects. Might as well add those of us that don’t live either in London or England full stop.

This in fighting is also exactly what the government want because it stops us blaming them. All the threads about Janet down the road seeing her granddaughter twice a week and Bob going for three walks a day instead of one all take away from the fact that we should be in uproar at the piss poor and negligent, at best, handling by our government.

I was on prepping threads back in January where posters were warning about this. You can’t tell me that if Susan on mumsnet knew enough to be concerned at the end of Jan, that the British government hadn’t been told about this at Christmas at the earliest. There is no excuse for what has happened here and each and every one of us should be shouting long and hard in their direction, not at each other and certainly not demanding people are forcibly quarantined away from their own families and freedom simply for doing a really hard job at the best of times.

[Whatthefoxgoingon]

Masters in economics you say? Oh well that’s alright then. Let’s all just all isolate care home workers and all NHS staff in their respective workplaces until the next decade. Who gives a shit whether they have lives, families etc. Just as long as the rest of us can get on with our lives uninterrupted. Thanks so much for solving this crisis.

[justdontatme]

Seriously @mayoral, if you were a care worker, A&E receptionist, hospital cleaner, doctor, whatever, would you be willing to pack up everything, leave your kids behind (hope there’s another parent to care for them) & go sleep at work for the duration?

Would you be willing to do it under certain circumstances? I can imagine if incentives were offered eg wiping out of all student loans you might get more takers. Mind you, I suppose they are wiped out with death anyway.

[C8H10N4O2]

my piece of paper that says I have a masters in economics

You might want to check the T&C around refunds.

[quietheart]

@AlohaMolly you are so right, this government are masters of deflection.

[Marnie76]

OP do you realise how many people work in a hospital? It’s not only doctors and nurses. The thousands of support staff, cleaners, porters etc. Are you suggesting that all of these people and their families (as I’m sure you can’t think it would be ok for them to leave behind their families for who knows how long) be isolated in hotels? But what if some of their families also support other vulnerable people in the community or have jobs to go to. Do you not see that it’s not workable. People don’t live in a vacuum. Your life Is being disrupted so is everyone else’s.
And the name calling 😳. The thing is you haven’t come up with a solution at all have you. Come back when you’ve come up with an actual decent idea. We’ll be waiting.

[Walkaround]

mayoral - I think you’ll find it’s spreading rapidly in the busiest places where distancing is impossible, otherwise known as care homes and hospitals. Self-evidently, if everyone else gets on with their lives, as in goes completely back to “normal”, it will spread rapidly in the rest of the community, too.

And what makes you think housing doctors, urses, cleaners, porters, carers, etc in hotels will help? Will they all be sharing the hotel kitchens, or will they be mixing with hotel staff? How do they socially distance when all sharing the same space? Will there be an outbreak of hotel fires, because they all get given camping stoves for their rooms?! And who will be looking after their families while they live in hotels?

[1forsorrow]

I did see a care home in the Isle of Wight did exactly that. The staff left their families and moved in Quite alot of homes have done it, I know of two one where a close relative lives and another with a more distant relative. Not all staff can do it, I do some voluntary work in a home that has a minority of staff with children under 18, a number of them are single and have volunteered to move in but if you have a home with lots of carers with young children, particularly if they are single parents, it is alot harder to do.

[Thingybob]

Sorry you got such a kicking on here OP. I don't think your suggestion is unworkable, for care homes at least. As a previous poster said it would be phenomenally expensive but a drop in the ocean compared with the cost of lockdown so I see no reason the government shouldn't throw money that way. I would suggest that nobody would be forced to do it and that all those that did should be paid at least double the minimum wage. Lock in time for carers should be limited to 4-6 weeks before staff are replaced by another team of previously quarantined staff. Many care staff currently choose to work that way as live-in carers for private clients so I see no reason why it would be different for care home staff. Yes I know it wouldn't be suitable for those with young children but if you go into any care home you'll see a large proportion of older women with grown up children or younger people without children.

[viewfromthecouch]

All the people who work in hospitals/care homes, who deliver food, supplies, inspect manage ... they all go home to their families each day. They go to shops to buy food. They travel with the public. Their children may still be going to school so they can do their jobs, thus exposing school staff and other kw and vulnerable children. And so on...