The Lemon Fool

I wonder what lessons have been learned in dealing with the next novel viral pandemic that hits?

It may be a bit early to come to final conclusions but surely after more than a year of dealing with the present pandemic, some lessons may have been learned.

Perhaps there are still more questions than answers but some of the ones that spring to mind for me are:

What can be done to reduce the spread of the virus internationally?

Do you shut down borders?

Do you test at the borders?

Do you enforce strict quarantine from the start?

Once the virus is in circulation within a country, what then?

Should you lockdown, hard and quickly?

Should masks be mandatory?

How best to run test and trace?

How best to ensure those tested positive isolate fully?

What parts of normal life are safe and what needs to be shut down?

How do you balance economic vs public health considerations?

Still more questions than answers I suppose.

redsturgeon wrote:I wonder what lessons have been learned in dealing with the next novel viral pandemic that hits?

...

Still more questions than answers I suppose.

Who decides it's a novel viral pandemic, and how, and when?

"This is The New Killer Virus That Will End Humanity"

Comment: "Remember, the first confirmed case of COVID-19 was diagnosed 2 days after this was uploaded. "

https://www.youtube.com/watch?v=-Jhz0pVSKtI

I reckon more than a few breeding pairs will survive.


Julian F. G. W.

I think we have mainly learned that being prepared in advance is a good idea. I imagine we will fund such preparedness for the next 10 years, and then we'll get bored and close down all the planning units just before another pandemic strikes. There will be another one. Might be next year, might be next century.

The answers to some of your questions of course depend on the virus. One that spreads through fluids (ebola, HIV) obviously needs different precautions from one that spreads via sneezing. And critically, is it infectious before symptoms appear?

jfgw wrote:"This is The New Killer Virus That Will End Humanity"

Comment: "Remember, the first confirmed case of COVID-19 was diagnosed 2 days after this was uploaded. "

https://www.youtube.com/watch?v=-Jhz0pVSKtI

I reckon more than a few breeding pairs will survive.


Julian F. G. W.

I notice he mentions travel bans as the very first thing to do when a "New Killer Virus That Will End Humanity" happens, as if he thinks everyone would naturally agree!

It seems that a pandemic like this happens about every 50 years or so. That is just enough time for everyone who remembers the last one as an adult to have died off, and so we have to start over again each time learning what to do.

One obvious problem is that the UK healthcare system is designed to operate at near 100% capacity in normal times. So when anything like this happens it cannot cope very quickly. Indeed the NHS has only coped by ignoring people with most other ailments, and by postponing surgical treatments, leaving us with a waiting list that could take years to work through.

It is rather like how Heathrow operates at near 100% capacity all day, every day, in normal times anyway. So that if there is any problem on a runway there are huge delays and diversions. And yet people have spent 50 years fighting the third runway.

Lootman wrote:It seems that a pandemic like this happens about every 50 years or so. That is just enough time for everyone who remembers the last one as an adult to have died off, and so we have to start over again each time learning what to do.

One obvious problem is that the UK healthcare system is designed to operate at near 100% capacity in normal times. So when anything like this happens it cannot cope very quickly. Indeed the NHS has only coped by ignoring people with most other ailments, and by postponing surgical treatments, leaving us with a waiting list that could take years to work through.

One can't help wondering who "designed" it that way and why.

XFool wrote:

Lootman wrote:It seems that a pandemic like this happens about every 50 years or so. That is just enough time for everyone who remembers the last one as an adult to have died off, and so we have to start over again each time learning what to do.

One obvious problem is that the UK healthcare system is designed to operate at near 100% capacity in normal times. So when anything like this happens it cannot cope very quickly. Indeed the NHS has only coped by ignoring people with most other ailments, and by postponing surgical treatments, leaving us with a waiting list that could take years to work through.

One can't help wondering who "designed" it that way and why.

Of course it runs at 100% capacity.
If we added 20% capacity, it would run at 100% of that higher capacity.
Unless there wasn't a single person waiting for any operation, why wouldn't you run at 100% capacity?

murraypaul wrote:

XFool wrote: One can't help wondering who "designed" it that way and why.

Of course it runs at 100% capacity.
If we added 20% capacity, it would run at 100% of that higher capacity.
Unless there wasn't a single person waiting for any operation, why wouldn't you run at 100% capacity?

To cope with emergencies? But I guess you've illustrated the (political) problem.

XFool wrote:

murraypaul wrote: Of course it runs at 100% capacity.
If we added 20% capacity, it would run at 100% of that higher capacity.
Unless there wasn't a single person waiting for any operation, why wouldn't you run at 100% capacity?

To cope with emergencies? But I guess you've illustrated the (political) problem.

In emergencies you just extend the waiting lists again.
Rather than having them extended a little bit all the time.

What extra capacity do you maintain? If we answered the question in April 2020 we'd be hip deep in pointless respirators.

The best extra capacity is a diverse and flexible economy, including manufacturing, research and training, so that applicable resources are available to be diverted at need.

9873210 wrote:The best extra capacity is a diverse and flexible economy, including manufacturing, research and training, so that applicable resources are available to be diverted at need.

Indeed. But how do you maintain that when the cost optimum solution to all manufacturing is massive-scale centralised and inflexible? Who is going to pay for it?

It's no use just having respirator manufacturers. You also need electric motor manufacturers, oxygen manufacturers, computer control manufacturers, light bulbs... And ALL of those work most efficiently if massive scale and centralised.

As stated by Midsmartin, I reckon the whole lot gets sold off and closed down as too small and inefficient just before the next emergency needs them. (Not just pandemics, there's climate, wars, meteorites, zombie apocalypse...)

Gryff

9873210 wrote:What extra capacity do you maintain? If we answered the question in April 2020 we'd be hip deep in pointless respirators.

The best extra capacity is a diverse and flexible economy, including manufacturing, research and training, so that applicable resources are available to be diverted at need.

With robust, diversified , short (UK?) supply chains. No relying on PPE from Ulan Bator, or vaccines from Flanders

Fighting the last war here. Next time it’ll be something else.... https://www.bbc.co.uk/sounds/play/b03ynts6 makes our lack of PPE look tame in comparison.

gryffron wrote:

9873210 wrote:The best extra capacity is a diverse and flexible economy, including manufacturing, research and training, so that applicable resources are available to be diverted at need.

Indeed. But how do you maintain that when the cost optimum solution to all manufacturing is massive-scale centralised and inflexible? Who is going to pay for it?

It's no use just having respirator manufacturers. You also need electric motor manufacturers, oxygen manufacturers, computer control manufacturers, light bulbs... And ALL of those work most efficiently if massive scale and centralised.

As stated by Midsmartin, I reckon the whole lot gets sold off and closed down as too small and inefficient just before the next emergency needs them. (Not just pandemics, there's climate, wars, meteorites, zombie apocalypse...)

Gryff

IMHO the mass-scale centralized manufacturing did quite well. Had the world needed millions of respirators we would have had them by mid-2020. We started mass producing vaccine in less than a year. Large-scale manufacturing is not anywhere near as inflexible as you believe.

The alternative to long international supply chains is not short national supply chains, it is no supply. 60 million people simply cannot support the same diversity or productivity as 6,000 million.

Snorvey wrote:You can have the same argument for anything. Do we maintain a huge standing army, a large navy and squadron upon squadrons of fighter aircraft just in case the Russians come over the hill?

Pointless - although it might give a job to young folk if they don't have anything else to go to....

Arguably though, maintaining a huge standing army and squadrons of fighter aircraft is the reason the Ruskies don't come over the hill, Shirley.

9873210 wrote:IMHO the mass-scale centralized manufacturing did quite well. Had the world needed millions of respirators we would have had them by mid-2020. We started mass producing vaccine in less than a year. Large-scale manufacturing is not anywhere near as inflexible as you believe.
The alternative to long international supply chains is not short national supply chains, it is no supply.

Yes, but they’re OUR respirators/vaccines/PPE... as the current situation has amply demonstrated, during a crisis everyone suddenly gets very parochial.

And whilst 6bn people can undoubtedly do more than 60M, we’re talking about reasonably basic technologies here. Not supercomputers and space rockets.

If you want a fast independent response, then centralised global production is not the answer.

Gryff

I'm surprised to see little mention of how we handled transfers between NHS hospitals and nursing homes yet....

With such a contagious airborne virus as COVID, it often seemed to be the case in the earlier months of the pandemic that we were doing everything possible to actively infect large parts of our most vulnerable population -

1. Poor isolation control in NHS hospitals (probably related to PPE, process, staffing, staff-control, etc...)

2. Poor in-hospital testing carried out when NHS beds needed to be cleared, ready to accept the most poorly incoming patients, so that pre-infected elderly (see point 1...) were often then shuttled back out into nursing homes from many hospitals, as local super-spreader injections into those most-susceptible of elderly populations...

3. Poor staffing situations in many of the UK nursing homes, with many, many care-staff often working multiple shifts across wider nursing home estates, with little chance of containing what we now know is often an asymptomatic disease, thus doubling-down on those NHS injections into the nursing homes with pre-infected people, by enabling the further cross-fertilisation of those infections between many of the poorly-equipped (PPE, process, staffing, staff-control etc...) nursing homes themselves....

There's no easy answers, of course, but I shudder to think of the number of unnecessary deaths that have been created by a mix of the above three situations in the UK over the past 16 months or so....

Cheers,

Itsallaguess

Itsallaguess wrote:I'm surprised to see little mention of how we handled transfers between NHS hospitals and nursing homes yet....

With such a contagious airborne virus as COVID, it often seemed to be the case in the earlier months of the pandemic that we were doing everything possible to actively infect large parts of our most vulnerable population -

1. Poor isolation control in NHS hospitals (probably related to PPE, process, staffing, staff-control, etc...)

2. Poor in-hospital testing carried out when NHS beds needed to be cleared, ready to accept the most poorly incoming patients, so that pre-infected elderly (see point 1...) were often then shuttled back out into nursing homes from many hospitals, as local super-spreader injections into those most-susceptible of elderly populations...

3. Poor staffing situations in many of the UK nursing homes, with many, many care-staff often working multiple shifts across wider nursing home estates, with little chance of containing what we now know is often an asymptomatic disease, thus doubling-down on those NHS injections into the nursing homes with pre-infected people, by enabling the further cross-fertilisation of those infections between many of the poorly-equipped (PPE, process, staffing, staff-control etc...) nursing homes themselves....

There's no easy answers, of course, but I shudder to think of the number of unnecessary deaths that have been created by a mix of the above three situations in the UK over the past 16 months or so....

Cheers,

Itsallaguess

I find it hard to separate things which were done because TPTB didn't know any better, from things which were done for expediency.
We now know that a characteristic of Covid is that perhaps one third of people infected show no symptoms, and that symptomless people (perhaps before symptoms appear) can still transmit the virus. I don't think that was fully appreciated early on, but it makes a big difference to the effectiveness of the response.

Releasing infected elderly into care homes (in many cases untested because testing was not available) - did TPTB assume these people were not infectious, or did they take the cynical view that hospital beds, in particular ICU beds, were in short supply, so hospitals had to be cleared of expendable people, to make way for those who were worth saving?

This infection has really put the focus on UK hospitals, where by some estimates 25% of infections were acquired (I think I read that somewhere). It suggests that infection control and isolation, as was the norm 50-100 years ago before antibiotics, have not been up to scratch. A major review of hospital design, ventilation, staffing, size, number of beds, spaciousness etc should be part of the Covid inquiry IMHO.

Nimrod103 wrote:This infection has really put the focus on UK hospitals, where by some estimates 25% of infections were acquired (I think I read that somewhere). It suggests that infection control and isolation, as was the norm 50-100 years ago before antibiotics, have not been up to scratch. A major review of hospital design, ventilation, staffing, size, number of beds, spaciousness etc should be part of the Covid inquiry IMHO.

Is it a case of déjà vu all over again?

Remembering the 2008 banking crisis, many people recalled from their youth tales of "silly old people" who were reputed to so distrust banks that they kept their savings under the mattress. Now we recall all those "old fashioned" hospitals and medics and their obsession with "fresh air".