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IOM Covid removing restrictions


Filippo

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30 minutes ago, trmpton said:

The post about the figures was directly in response to @Roger Mexicoquoting the previous days figures as some sort of justification for what he was saying.

In fairness think he just could not be stuffed to look up 7 day average, but we all got the idea. Since otherwise open border brigade will quote Monday number since registry offices shut on Sunday and the lets lock ourselves in basement brigade will to quoting Tuesday number.

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2 minutes ago, quilp said:

https://www.gov.je/Health/Coronavirus/Pages/CoronavirusCases.aspx

Jersey (Uk) stats as of today. Make of them what you will.

School year group also being sent home as cases rise.

https://jerseyeveningpost.com/news/2020/11/05/school-year-group-sent-home-after-covid-case-is-confirmed/

 

An honest and open breakdown of the current and past situation that includes a little bit of inconvenience in return for an open and clearly communicated policy that doesn’t cripple the local economy or stop loved ones seeing their family and friends.

Looks good to me

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2 minutes ago, trmpton said:

An honest and open breakdown of the current and past situation that includes a little bit of inconvenience in return for an open and clearly communicated policy that doesn’t cripple the local economy or stop loved ones seeing their family and friends.

Looks good to me

Yeah. So far so good over there then. We'll see how it looks this time next week because all the cases they have (97) appear to be in the community. 

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1 minute ago, quilp said:

Yeah. So far so good over there then. We'll see how it looks this time next week because all the cases they have (97) appear to be in the community. 

Deal.

Let’s do it properly and review in six months when we have an overall picture of the economic and emotional  impact balanced against the number of deaths per head of population on each island.

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48 minutes ago, quilp said:

Yeah. So far so good over there then. We'll see how it looks this time next week because all the cases they have (97) appear to be in the community. 

Well if you test in arrival you get a lot more cases, Guernsey upto 12 as also testing on arrival now. No doubt if we did any testing eg on arrival, 7 days etc we would show up more but we only test on symptoms or going into hospital so not getting the data.

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8 hours ago, jaymann said:

1) We will supposedly hit Level 2 (I think) of our Border Framework when the UK reaches infection rate 20/100K of population. Yet when Guernsey had a small controlled outbreak reflecting 5/100K of population, the bridge was instantly shut down, rightly or wrongly.

I thought same think, and to differentiate with Liverpool (500 odd/100K at time) and if deemed sufficient demand then was thinking could keep link with 7 day test. Since if people crack from being on Island only had Liverpool as option.

8 hours ago, jaymann said:

3) Our financial services sector is leaking considerable amounts of business to Jersey, considerable amounts.

How does anyone know this happening? And secondly if this is happening how do we know reasons for such have anything to do with COVID policy? Maybe people are moving here from Jersey (I would be) since as we know best to be citizen on one country, live in another and have assets in a third.

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1 hour ago, quilp said:

Yeah. So far so good over there then. We'll see how it looks this time next week because all the cases they have (97) appear to be in the community. 

They mention this led to 800+ leads for contract tracing, hope testing up to speed but at some point local tracking must breakdown due to weight of numbers, which will be growing like power function as you move each hop away from the source.

1 hour ago, trmpton said:

Deal.

Let’s do it properly and review in six months when we have an overall picture of the economic and emotional  impact balanced against the number of deaths per head of population on each island.

Will be interesting to tally up all numbers after this, hard to measure emotional impact but could put metric to various measures of liberty, and I would throw in Long COVID effects. BMJ claims 10% COVID patients reporting symptoms 12 weeks after infection, which is how they classify Long COVID.  

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7 hours ago, Escape Artist said:

You are actually providing a truly convincing justification for "focused protection" rather than indiscriminate segregation of the whole population.

Your graph show negligible fatality risk for the under 40. Yes, some people may have specific health issues that need to be taken into account.

 

For IoM the shielding group taking into account these peoples likely immediate social network could mean 30K people. Idea is simple particularly for 1st degree relatives, if an outbreak occurred then all social network would change behaviour. At least people I know would opt to lose (say) going out to pub over risk of potentially passing on pathogen to a family member at significant risk of serious illness from that pathogen. Theoretically you could split island onto two and say all people who want tight controls go into one area and other with no controls into other..... But in practice that not workable. The networks are embedded. You have front line medics on IoM (who I know) who have close family members who are at high risk, ditto I assume all other sections of economy, biggest fear for such people is risk of infecting their own family. You can say high-risk people should isolate themselves, brings number down to 3,400; which likely to happen anyway in significant outbreak, but the effect on society particularly economically will be disproportionate. Remember the shielding group are typically 35-70 (over 70 not in this group [explain why I think later], young rarely have chronic disease) bulk of years when have greatest earning power. Reason I believe over 70s not put in this group is because of metric used by NICE (National Institute of Clinical Excellent) which measures expected value of 'addition quality life years' as a measure of whether a procedure/drug if effective. Clearly as get older your years left reduces, so COVID interventions have less life expectancy years to win. But besides 4% shielding people I would expect over 70s to also radically change behaviour on significant outbreak. Whatever NICE says, I do not think they are keen on risk of becoming very ill.

With above cancer data, cancer is a disease in main of old age, and reason additional no risk for under 40, is because the set is empty (in this case). If want to consider another risk group could consider autoimmune conditions which effects all ages (even few kids, but mostly over 30). Here a BMJ study I found:

https://ard.bmj.com/content/annrheumdis/79/7/859.full.pdf

which for this group put hospitalisation risk at 46% and mortality at 9%. Break down by comorbidity but shame did not stratify by age but guess with only 600 people over various conditions data set not big enough. But there again I guess if in this box and saw COVID coming you would lock yourself in the cellar (if you had one).  

Looking at UK data on how prevalent these conditions are, I would estimate have 300 rheumatic disease patients on IoM, but load other conditions mentioned too, so 500 could be closer estimate (I just do not know). But say assume have 300 in this box, and the all get infected, report has 46% hospitalisation rate so end up with 136 of them in Nobles. Nobles has 200 beds and 6 ICU beds (in standard configuration). So just this group of 300 people could bring Nobles to its knees.

For everyone, you definitely want to reduce the risk of people who are extremely clinically vulnerable of getting infected. As said in previous post stratification of risk is particularly large for this pathogen, so you would expect behavior of different risk groups to vary and I think makes sense for state to manage risk for all for greatest common good. That means steps to reduce spread of pathogen and get such groups to take much stricter precautions than general population. 

Finally, reason I keep banging on about PPE at Nobles is because such groups are going through there all the time bunched up in enclosed indoor spaces. We have continually had patients and medics going back and forth to Liverpool, all hospitals all time have tight infection controls but bacterial and virus infections happen all time (I believe 25% infections occur in hospitals but cannot find reference, but number is large). Staff canteen upstairs and everyone there eating and chatting in close quarters, in clinics have fixed protocols but upstairs people will relax which is natural. Anyway, good to hear someone at hospital must have told someone in Government about use of PPE in Nobles and risk. Two COVID positive patients must fucused minds but I think transmission risk been present all time. Last I heard was in August management told frontline staff to stop using face coverings at Nobles, while UK Health, UK NHS and SAGE where saying exactly opposite, see:

https://www.gov.uk/government/news/face-masks-and-coverings-to-be-worn-by-all-nhs-hospital-staff-and-visitors   

view of this advice varied between medics, but it appeared from various conversations, at least coincidently, that medics with family members in high-risk groups would have preferred to keep facemasks while those without had a more relaxed opinion.   

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