IOM Covid removing restrictions

[Ramseyboi]

1 hour ago, the stinking enigma said:

I can only think ashie has been promised a seat on legco if it all goes tits up for him in the elections.  

That would be a gamble. Given we currently have no MHKs and don’t know who will be casting the votes!

[747-400]

3 hours ago, Gladys said:

HD, it wasn't the lack of action so much as ignoring strong advice from, and lack of consultation with, those qualified and employed to give it that is the real kicker here.

It isn't really the response to Covid that is the concern, but the systemic flaws the response reveals. 

Why was the Director of Public Health moved to the Cabinet Office? 

Stated in the rebuttal that it had already been agreed, prior to COVID, as part of some transformation programme. 

Edited August 12, 2021 by 747-400
typo

[Declan]

2 hours ago, Annoymouse said:

Without intending to be disrespectful towards Dr Glover, Dr Ranson hasn’t vented her frustration publicly through the likes of Twitter or social media though, she has maintained her professionalism throughout and it’s a lot harder to bite your tongue then it is to shout out loud and tell the world.

Again I do understand Dr Glovers actions, no longer being employed by DHSC (never employed by DHSC apparently!) meant she didn’t need to be careful about voicing her opinion.

Also, Dr Ranson has an Employment Tribunal pending in which (according to the AG's letter contained in the PAC pack) she alleges that she has suffered 20 detriments "visited upon her" as a result of making disclosures about the DHSC. And DHSC's submission to PAC calls her unprofessional. 

[Declan]

20 minutes ago, TheTeapot said:

https://www.manxradio.com/news/isle-of-man-news/dhsc-medical-directors-evidence-inaccurate/

Another professional, qualified woman criticises the DHSC in detail and is castigated by the Government. A pattern emerges.

However, just like the point by point rebuttal of Dr Glover's evidence, the DHSC's response to Dr Ranson is harsh words and a few bullet points. Worryingly Manx Radio seem to be giving equal weight to both sides - hours of testimony versus a memo! Then of course Ashford will do follow up interviews disassembling all the time but Dr R won't get that chance.

[wrighty]

Well I'm named in this evidence, so I feel I should give my side of things.  I may as well do it here as I've not been asked by the PAC, and I don't do twitter.

I remember Dr Ranson calling the meeting of the senior medics of which I was one on the Sunday afternoon, 15th March 2020.  We agreed how serious the situation could become, and set out a series of things the government should be doing, immediately, to convey that seriousness.  At that time some people were still talking about holding TT - this was one of the suggestions we made.  The following day TT cancellation was announced.  We felt the message was getting through.  There were clearly some comms difficulties though.  The Gold/Silver/Bronze structure seemed clumsy, and as the clinical advisory group (CAG, sometimes including Public Health, sometimes not) we were unsure which group we should be feeding into.  Technically it was 'Bronze Command', but it sometimes felt like we'd agree a paper, pass it to bronze, and then hear nothing more about it.  Rosalind was frustrated by this, and was also under immense pressure feeling that as well as Medical Director she was also the de facto Public Health service and locum Chief Exec - Kathryn Magson was based in the UK at this stage, and Dr Ewart was on holiday.

At this point I should say that Dr Ranson deserves huge credit for pulling together and leading the response at Noble's and in Primary Care.  Without her grabbing the bull by the horns that Sunday afternoon I shudder to think what might have happened over here.

Moving on, I was asked to look at the rudimentary modelling that had been done.  I'm known as the maths geek, and am better qualified than most to do this sort of thing, although I'm not a professional epidemiologist.  I started from scratch, and made my own model, coincidentally completing the first draft on 19th March, the same day we got our first confirmed case.  The outputs were frightening.  Rosalind and I went to Government to meet David Ashford and Howard Quayle, prior to the briefing on 25th March.  By that stage it had been decided to lockdown, and showing them the model reinforced the decision.

Over the next few days I refined the model.  I was puzzled by the number of deaths in Italy and Spain, which seemed to be levelling off at numbers way lower than the 5-600000 predicted by Imperial.  I did some more sums, and extrapolated the death data coming out of various countries who had been hit before us.  I put their demographic into my model, and used it to calculate a key figure - the proportion of the population susceptible to covid.  This came out at 2.5% or thereabouts, way under the 80% used by Imperial.  This figure made little sense, but seemed to work to give the right sized curves.  Based on this, our numbers were coming out much lower than the initial horror stories, and I argued against the need to build a Nightingale style hospital at the NSC.  The group agreed to this at a presentation I gave on 1st April (I think) and we instead repurposed ward 20 to cohort positive cases from the community in an effort to prevent Nosocomial Amplification.  Apart from Abbotswood, this strategy worked.  Lockdown worked, we suppressed cases and achieved local elimination, and in June we were back to normal, except for travel.

Hindsight is always 20/20.  Rosalind couldn't accept, a few months later, that my model was correct.  Specifically the 2.5% figure I used for susceptibility.  She was right, in hindsight, but by the time we were arguing about it with more data that had come out, it didn't really matter.  The model was no longer relevant as we had local elimination.  When I made it, there was genuine doubt about how many were susceptible to covid.  There were plenty of papers talking about t-cell mediated immunity, and cross-reactivity with other coronavirus infections.  I thought 2.5% was very low, but the numbers worked.  In hindsight, 2.5% is what you get with an effective lockdown brought in just as you're getting your health services overwhelmed.  We locked down before anyone else in Europe (even though it could have perhaps been sooner) and consequently had fewer hospital admissions and deaths in the first wave.

If that's tl;dr the summary is this:  Dr Ranson showed great leadership at the outset, but was under immense pressure even though supported by the senior medics in the hospital.  Her issue later on was that she couldn't just 'let go' of something and move on.  Everything had to be right, with all i's dotted and t's crossed.  Even at the expense of pragmatism as the issue was no longer pertinent.  And this led to some difficulties in her working relationship with both her bosses and some of the senior medics.  She got us through the first wave though, and for that she deserves much credit.

[John Wright]

5 minutes ago, wrighty said:

Well I'm named in this evidence, so I feel I should give my side of things.  I may as well do it here as I've not been asked by the PAC, and I don't do twitter.

I remember Dr Ranson calling the meeting of the senior medics of which I was one on the Sunday afternoon, 15th March 2020.  We agreed how serious the situation could become, and set out a series of things the government should be doing, immediately, to convey that seriousness.  At that time some people were still talking about holding TT - this was one of the suggestions we made.  The following day TT cancellation was announced.  We felt the message was getting through.  There were clearly some comms difficulties though.  The Gold/Silver/Bronze structure seemed clumsy, and as the clinical advisory group (CAG, sometimes including Public Health, sometimes not) we were unsure which group we should be feeding into.  Technically it was 'Bronze Command', but it sometimes felt like we'd agree a paper, pass it to bronze, and then hear nothing more about it.  Rosalind was frustrated by this, and was also under immense pressure feeling that as well as Medical Director she was also the de facto Public Health service and locum Chief Exec - Kathryn Magson was based in the UK at this stage, and Dr Ewart was on holiday.

At this point I should say that Dr Ranson deserves huge credit for pulling together and leading the response at Noble's and in Primary Care.  Without her grabbing the bull by the horns that Sunday afternoon I shudder to think what might have happened over here.

Moving on, I was asked to look at the rudimentary modelling that had been done.  I'm known as the maths geek, and am better qualified than most to do this sort of thing, although I'm not a professional epidemiologist.  I started from scratch, and made my own model, coincidentally completing the first draft on 19th March, the same day we got our first confirmed case.  The outputs were frightening.  Rosalind and I went to Government to meet David Ashford and Howard Quayle, prior to the briefing on 25th March.  By that stage it had been decided to lockdown, and showing them the model reinforced the decision.

Over the next few days I refined the model.  I was puzzled by the number of deaths in Italy and Spain, which seemed to be levelling off at numbers way lower than the 5-600000 predicted by Imperial.  I did some more sums, and extrapolated the death data coming out of various countries who had been hit before us.  I put their demographic into my model, and used it to calculate a key figure - the proportion of the population susceptible to covid.  This came out at 2.5% or thereabouts, way under the 80% used by Imperial.  This figure made little sense, but seemed to work to give the right sized curves.  Based on this, our numbers were coming out much lower than the initial horror stories, and I argued against the need to build a Nightingale style hospital at the NSC.  The group agreed to this at a presentation I gave on 1st April (I think) and we instead repurposed ward 20 to cohort positive cases from the community in an effort to prevent Nosocomial Amplification.  Apart from Abbotswood, this strategy worked.  Lockdown worked, we suppressed cases and achieved local elimination, and in June we were back to normal, except for travel.

Hindsight is always 20/20.  Rosalind couldn't accept, a few months later, that my model was correct.  Specifically the 2.5% figure I used for susceptibility.  She was right, in hindsight, but by the time we were arguing about it with more data that had come out, it didn't really matter.  The model was no longer relevant as we had local elimination.  When I made it, there was genuine doubt about how many were susceptible to covid.  There were plenty of papers talking about t-cell mediated immunity, and cross-reactivity with other coronavirus infections.  I thought 2.5% was very low, but the numbers worked.  In hindsight, 2.5% is what you get with an effective lockdown brought in just as you're getting your health services overwhelmed.  We locked down before anyone else in Europe (even though it could have perhaps been sooner) and consequently had fewer hospital admissions and deaths in the first wave.

If that's tl;dr the summary is this:  Dr Ranson showed great leadership at the outset, but was under immense pressure even though supported by the senior medics in the hospital.  Her issue later on was that she couldn't just 'let go' of something and move on.  Everything had to be right, with all i's dotted and t's crossed.  Even at the expense of pragmatism as the issue was no longer pertinent.  And this led to some difficulties in her working relationship with both her bosses and some of the senior medics.  She got us through the first wave though, and for that she deserves much credit.

Thank you. 

[Utah 01]

16 minutes ago, Declan said:

Then of course Ashford will do follow up interviews disassembling all the time but Dr R won't get that chance.

If anyone believes a word spewed forth from any politician's mouth, then they deserve all the misfortune that these amateurs will continue pour upon them.

The management of the DHSC (still all women?) has been nothing but dreadful and incompetent for years with this latest debacle being just one of many that don't even reach the press or the propaganda Radio.  How long ago was it that their gross mismanagement was exposed by the poor chap who had become 'stuck' in Cyprus and was deducted pay?

The bureaucratic, self-serving DHSC management is an impediment to the hard-working and dedicated front-line staff that keep the system running despite the laughable 'managers' inabilities and overseen by an even more clueless politician.

Edited August 12, 2021 by Utah 01

[AlanShimmin]

9 minutes ago, Utah 01 said:

How long ago was it that their gross mismanagement was exposed by the poor chap who had become 'stuck' in Cyprus and was deducted pay?

Wasn't that a Douglas Borough Council fuck up instead of a DHSC fuck up?

[Utah 01]

14 minutes ago, wrighty said:

Everything had to be right, with all i's dotted and t's crossed.  Even at the expense of pragmatism as the issue was no longer pertinent. 

That is a leadership failing - period.

Alas, those traits are now all too common in decision making processes from even lower levels to the very top of management structures.

In posh-speak, it termed 'risk aversity'; colloquially, it termed 'covering your arse'.  Whichever term takes your fancy, the affliction can paralyse the decision-making process.

 

[Utah 01]

1 minute ago, AlanShimmin said:

Wasn't that a Douglas Borough Council fuck up instead of a DHSC fuck up?

In retrospect you're quite right and I stand corrected - however, it remains symptomatic of the level of competency witnessed throughout all levels of administration here.

[Boo Gay'n]

59 minutes ago, TheTeapot said:

https://www.manxradio.com/news/isle-of-man-news/dhsc-medical-directors-evidence-inaccurate/

This is quite a sinister media release (presumably where MR got its copy) in its reference to 'unprofessional'.  For medics, I think, that is code for you might have broken your professional code and could be referred to the GMC, which could then end your career.

I'll bet that Hetty got a cob on and has huffed and puffed about the criticism of her.

[Banker]

71 new cases, 16 in hospital up 3 

[quilp]

Blimey, we've topped the list..!

https://www.echolive.ie/nationalnews/arid-40357025.html

 

[Declan]

30 minutes ago, wrighty said:

Her issue later on was that she couldn't just 'let go' of something and move on.  Everything had to be right, with all i's dotted and t's crossed.  Even at the expense of pragmatism as the issue was no longer pertinent.  And this led to some difficulties in her working relationship with both her bosses and some of the senior medics.  She got us through the first wave though, and for that she deserves much credit.

 

12 minutes ago, Utah 01 said:

That is a leadership failing - period.

Alas, those traits are now all too common in decision making processes from even lower levels to the very top of management structures.

In posh-speak, it termed 'risk aversity'; colloquially, it termed 'covering your arse'.  Whichever term takes your fancy, the affliction can paralyse the decision-making process.

 

It's not a bad trait when talking about statistical models during a pandemic though. Nor is pragmatism. Her comments about wrighty and his post here don't look like a major conflict.

[cissolt]

36 minutes ago, wrighty said:

 

If that's tl;dr the summary is this:  Dr Ranson showed great leadership at the outset, but was under immense pressure even though supported by the senior medics in the hospital.  Her issue later on was that she couldn't just 'let go' of something and move on.  Everything had to be right, with all i's dotted and t's crossed.  Even at the expense of pragmatism as the issue was no longer pertinent.  And this led to some difficulties in her working relationship with both her bosses and some of the senior medics.  She got us through the first wave though, and for that she deserves much credit.

Thanks Wrighty, I think you confirm some of the madness that was taking place at the start of the pandemic.  DPH going AWOL, Magson seemingly ineffective operating from the uk. 

It takes courage to stand up and try and do the right thing in the midst of a pandemic in that kind of environment.

The Imperial model was a doomsday scenario that was unfortunately being used by many governments to influence policy.

https://dailysceptic.org/code-review-of-fergusons-model/