Learning from Covid
Discussion
I was thinking on the drive back to the office this morning what a monumental f
k up this has been for everyone and what UK Government and others could do to avoid a repeat.
Given that it was all about NHS capacity and not overwhelming it, the answer must be to have reserve capacity which is kept on standby only for use in case of civil emergency/pandemic etc. Whilst this would be expensive it would surely be a fraction of what this has cost over the last 12 months.
I guess it's eminently feasible to have fully equipped but mothballed hospitals which could be brought on stream at short notice but how feasible would it be to have reserve staff (al la fire service/TA etc) to run them?
What do we think the Government might do to avoid a repeat or hedge against one?
k up this has been for everyone and what UK Government and others could do to avoid a repeat.Given that it was all about NHS capacity and not overwhelming it, the answer must be to have reserve capacity which is kept on standby only for use in case of civil emergency/pandemic etc. Whilst this would be expensive it would surely be a fraction of what this has cost over the last 12 months.
I guess it's eminently feasible to have fully equipped but mothballed hospitals which could be brought on stream at short notice but how feasible would it be to have reserve staff (al la fire service/TA etc) to run them?
What do we think the Government might do to avoid a repeat or hedge against one?
Lotobear said:
I guess it's eminently feasible to have fully equipped but mothballed hospitals which could be brought on stream at short notice but how feasible would it be to have reserve staff (al la fire service/TA etc) to run them?
What do we think the Government might do to avoid a repeat or hedge against one?
The Nightingale hospitals were built quickly, but were there enough trained staff to cover all the required rolls?What do we think the Government might do to avoid a repeat or hedge against one?
Assuming they did get staff cover, would it have been possible to quarantine the people that were CV positive in the Nightingales, and leave the "regular" NHS hospitals open to CV negative patients for regular treatment?
The key to fighting the affects of a virus are breaking chains of transmission so lesson one has to be implementing effective quarantine measures at the borders immediately. Lesson two would be implementing an effective track, trace and isolate program to mitigate against internal transmission. Lesson three would be having an effective online learning system to prevent significant interruption to education at all levels.
mcflurry said:
The Nightingale hospitals were built quickly, but were there enough trained staff to cover all the required rolls?
From what I remember staffing was the big issue. In the army we have the territorials, in the police we have the specials, maybe we need something similar for the NHS?21TonyK said:
From what I remember staffing was the big issue. In the army we have the territorials, in the police we have the specials, maybe we need something similar for the NHS?
Pretty much what I posed in my original post - I just can't think how that would work, what with needing to be up to speed in a care environment where protocols evolve and change all the time whilst the 'reservist' presumably also follows a full time career elsewhere. Perhaps it could work but it's the human resource which seems to be the problem.I think the first thing that must be accepted by us, the government and the media is that this sort of thing is going to happen more often, basically because there are too many people on the planet (things like Aids, Ebola, birdflu, SARS and Covid-19 come from where inroads into the natural environment are being made due to population pressure). We have got off very lightly with coronavirus, it has only killed a tiny tiny fraction of the population and most them were very elderly. We may have to accept we won't live as long in future, which is probably a good thing for the planet as a whole.
We certainly won't have the luxury of locking down the country every time this happens in future, the economic cost would be too great.
We certainly won't have the luxury of locking down the country every time this happens in future, the economic cost would be too great.
Agree at the outset what the strategic goal is - is it something like "Minimise the number of quality adjusted life years lost over the next 10 years" or "Minimise the total number of deaths". Different people will have different ideas here but we should decide on one.
Get a team of the nation's best scientists/statisticians/economists to build a model to test the effects of various policy measures and choose those that best achieve the chosen strategic goal based on evidence and not politics. New evidence, research and treatments will emerge and as they do, continually refine the model and reassess the best policy measures. Trust the model and don't change the policy measures based on perceived popularity, headlines in the media / what other countries are doing / social media comments and don't change the strategic goal however.
Where there is a need to do something like restrict people's movements, implement this quickly, communicate it clearly and enforce it firmly and consistently. It's better to have a policy that imposes a minor restriction that everyone follows than one that imposes a major restriction that is widely not followed.
Get a team of the nation's best scientists/statisticians/economists to build a model to test the effects of various policy measures and choose those that best achieve the chosen strategic goal based on evidence and not politics. New evidence, research and treatments will emerge and as they do, continually refine the model and reassess the best policy measures. Trust the model and don't change the policy measures based on perceived popularity, headlines in the media / what other countries are doing / social media comments and don't change the strategic goal however.
Where there is a need to do something like restrict people's movements, implement this quickly, communicate it clearly and enforce it firmly and consistently. It's better to have a policy that imposes a minor restriction that everyone follows than one that imposes a major restriction that is widely not followed.
Lotobear said:
21TonyK said:
From what I remember staffing was the big issue. In the army we have the territorials, in the police we have the specials, maybe we need something similar for the NHS?
Pretty much what I posed in my original post - I just can't think how that would work, what with needing to be up to speed in a care environment where protocols evolve and change all the time whilst the 'reservist' presumably also follows a full time career elsewhere. Perhaps it could work but it's the human resource which seems to be the problem.I've seen one example of this in practice, albeit a very small Gov department compared to the NHS as a whole.
The problem is that the NHS is really quite efficient and right sized for demand. Hence when you get excess demand there is little remaining capacity. Oddly German, French and Italian health services benefitted during COVID from being less efficient.
Although that still cannot stop individual areas / periods being overwhelmed.
The solution of back up service is neat, but what are these people doing when not called back in to the medical roles?
There were lots of recently retirees who came back in this period, where else is there an available source of medically trained, inactive people?
Although that still cannot stop individual areas / periods being overwhelmed.
The solution of back up service is neat, but what are these people doing when not called back in to the medical roles?
There were lots of recently retirees who came back in this period, where else is there an available source of medically trained, inactive people?
Lotobear said:
I was thinking on the drive back to the office this morning what a monumental fk up this has been for everyone and what UK Government and others could do to avoid a repeat.
Given that it was all about NHS capacity and not overwhelming it, the answer must be to have reserve capacity which is kept on standby only for use in case of civil emergency/pandemic etc. Whilst this would be expensive it would surely be a fraction of what this has cost over the last 12 months.
I guess it's eminently feasible to have fully equipped but mothballed hospitals which could be brought on stream at short notice but how feasible would it be to have reserve staff (al la fire service/TA etc) to run them?
What do we think the Government might do to avoid a repeat or hedge against one?
A number of reasonable suggestions but we have spunked a lot of future healthcare provision on this overreaction. Wealth pays for health and we have cut the economy off at the knees over the last 12 months. There will simply not be the money to have spare mothballed capacity, let alone increased spending on it.k up this has been for everyone and what UK Government and others could do to avoid a repeat.Given that it was all about NHS capacity and not overwhelming it, the answer must be to have reserve capacity which is kept on standby only for use in case of civil emergency/pandemic etc. Whilst this would be expensive it would surely be a fraction of what this has cost over the last 12 months.
I guess it's eminently feasible to have fully equipped but mothballed hospitals which could be brought on stream at short notice but how feasible would it be to have reserve staff (al la fire service/TA etc) to run them?
What do we think the Government might do to avoid a repeat or hedge against one?
If you have the option of private medical I would take it up. We have created a situation where a limited resource now has more demand for it than ever before, but there is no money to pay for it.
For everyone without the option of going private, future healthcare provision over at least the next decade and likely much longer, will be an inferior product to what was on offer in 2019.
Ashfordian said:
A number of reasonable suggestions but we have spunked a lot of future healthcare provision on this overreaction. Wealth pays for health and we have cut the economy off at the knees over the last 12 months. There will simply not be the money to have spare mothballed capacity, let alone increased spending on it.
If you have the option of private medical I would take it up. We have created a situation where a limited resource now has more demand for it than ever before, but there is no money to pay for it.
For everyone without the option of going private, future healthcare provision over at least the next decade and likely much longer, will be an inferior product to what was on offer in 2019.
Totally agree. Do I choose to finance my motorcycle or invest in private medical care?? I think I'll take my chances & keep the bike!If you have the option of private medical I would take it up. We have created a situation where a limited resource now has more demand for it than ever before, but there is no money to pay for it.
For everyone without the option of going private, future healthcare provision over at least the next decade and likely much longer, will be an inferior product to what was on offer in 2019.
Seriously though, I have learnt throughout this just what a taboo death is to your average Brit. As for the general public's grasp of personal risk assessment & statistics....
If it’s about protecting the NHS then why are we still locked down when numbers of admissions and people in hospital are falling through the floor?
Despite what they said, that ceased to be the true goal at some point as that would have implied “accepting” deaths up to the level of NHS capacity.
The people that wanted lockdowns and the government are responding to that rather the need to protect the NHS.
Therefore, I predict we will learn nothing and probably be more likely to repeat this whole charade at the first opportunity.
Despite what they said, that ceased to be the true goal at some point as that would have implied “accepting” deaths up to the level of NHS capacity.
The people that wanted lockdowns and the government are responding to that rather the need to protect the NHS.
Therefore, I predict we will learn nothing and probably be more likely to repeat this whole charade at the first opportunity.
Edited by dmahon on Monday 8th March 21:20
dmahon said:
Therefore, I predict we will learn nothing and probably be more likely to repeat this whole charade at the first opportunity.
I hope I'm wrong, but I think there's a medium chance that it's not going anywhere.Edited by dmahon on Monday 8th March 21:20
I can forsee a scenario where we bounce along over the summer for a bit at low rates with the vaccine roll out: That'll be countered with "Freedom Day" parties etc ensuring the spread to the non-vaccinated. The big petri dish will then ensure new variants pop up and come Autumn we'll be back where we started.
All IMO of course.
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