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Interesting analysis from the Guardian
” Why do female leaders seem to be more successful at managing the coronavirus crisis? ”
And one of the answers suggested is that having women leaders is a reflection of the political status of the society of egalitarianism and non-discrimination. I also think that it reflects a more politically mature society, where politics and politicians serve the interest of their people not the interests of the overinflated egos of the leaders and their vested interest. And this reminds us why we are in this mess we are in, because despite or because of a head start in democracy, countries like US and UK have not moved on with the times and still run extremely patriarchal societies, with the leaders as ultimate decision makers. That is the lesson that should be learned.SA, please check over my repliy to Nick, above, and correct if necessary.
China has rejected calls for an independent international investigation into the origin of the coronavirus.
https://www.bbc.co.uk/news/world-asia-china-52420536WHO could have guessed that?
Officially North Korea has no cases of covid-19
unofficially it is very bad.BEIJING/SEOUL (Reuters) – China has dispatched a team to North Korea including medical experts to advise on North Korean leader Kim Jong Un, according to three people familiar with the situation.
https://www.reuters.com/article/us-northkorea-politics-exclusive/exclusive-china-sent-team-including-medical-experts-to-advise-on-north-koreas-kim-sources-say-idUSKCN2263DWThe sources declined to be identified given the sensitivity of the matter.
Clark and Nick
The case fatality rate in different countries is all over the place. Here is an article that discussed the reasons why this is so. As Clark says, the case fatality rate always improves with time presumably because you always diagnose the more severe cases first as milder cases may escape attention and you will also get better at treating a disease that you become more familiar with in time. Of course there are many other demographic factors, as discussed in that website referred to above:Between countries, case Fatality rates vary significantly, and over time, which suggests considerable uncertainty over the exact case fatality rates.
1. The number of cases detected by testing will vary considerably by country;
2. Selection bias can mean those with severe disease are preferentially tested;
3. There may be delays between symptoms onset and deaths which can lead to underestimation of the CFR;
4. There may be factors that account for increased death rates such as coinfection, more inadequate healthcare, patient demographics (i.e., older patients might be more prevalent in countries such as Italy);
5. There may be increased rates of smoking or comorbidities amongst the fatalities.
6. Differences in how deaths are attributed to Coronavirus: dying with the disease (association) is not the same as dying from the disease (causation).But also I think that the overall mortality can only be ascertained after widespread testing and also after the end of the epidemic, or at least the first wave of the epidemic.
Nick @April 23, 2020 at 18:50
“Clark what you describe there from that nature article sounds very similar to anaphylactic shock.”
Only in so much as they are both phenomena whereby the immune response overreacts and causes damage but the mechanisms and the clinical picture are different. Anaphylaxis is mainly mediated by a type of immune protein called IgE which is associated with allergy. The reaction against a protein, say nuts in those with nut allergy, triggers the release of histamine which causes constriction of the bronchioli and a wheezing attack such as occurs in asthma and skin rashes and so on. The reaction described in the nature paper, also known as a cytokine storm, is triggered by a suboptimal immune response which instead of neutralising the invading agent, virus or bacteria, will instead cause an inappropriate release of chemicals called cytokines, which are intracellular messenger molecules that control certain immune responses. Such responses always have checks and balances but in the case of this inappropriate response, these do not function and an overreaction with damage to various organs, such as the lungs, blood vessels, kidney and heart can occur. Simplistically put!
Michael
Here is a view from the other side of the argument. I mention it not necessarily as an endorsement but just for balance.Among the myriad, earth-shattering geopolitical effects of coronavirus, one is already graphically evident. China has re-positioned itself. For the first time since the start of Deng Xiaoping’s reforms in 1978, Beijing openly regards the US as a threat, as stated a month ago by Foreign Minister Wang Yi at the Munich Security Conference during the peak of the fight against coronavirus.
Beijing is carefully, incrementally shaping the narrative that, from the beginning of the coronovirus attack, the leadership knew it was under a hybrid war attack. Xi’s terminology is a major clue. He said, on the record, that this was war. And, as a counter-attack, a “people’s war” had to be launched.Michael
April 25, 2020 at 11:21#52485
The calls for independent investigations come from Australia and USA with a background agenda to politicise a pandemic which both USA and U.K. have by all accounts, badly managed despite being warned and seeing the example set by China. In this case it is not the pot calling the kettle black, it’s the same calling fridge black.SA on Andrew Marr, this morning, some scientist was saying the real death toll in the U.K. has already surpassed 40,000
Andrew Marr asked Dominic Rabb if Kim Jong Un was alive or dead
Rabb said he had heard the cyber waffle but had no actual knowledge.If he has gone or been very ill from complications of covid-19
North Korea, which claims none, must be crawling with covid-19Now more than three millions victims.
The U.K. has now overtaken Germany, both in deaths and numbers.
Today the U.K. is adding death from covid-19 in care homes and other settings in with our hospital death figures.
However Germany, perhaps a touch over confident, is possibly coming into a second wave of infections.Germany imposed lockdown when they had about 58,000 infections, whereas the UK locked down at about 260,000. Those figures are from ICL’s model, and they’re estimates for all actual infections rather than just those tested or otherwise diagnosed. But ICL’s model seems to be very good at predicting death rates in multiple countries.
Sweden, and to a lesser extent Belgium are the ones to watch. They haven’t yet got the reproduction number Rt below 1, so their epidemics are still increasing.
It now seems that the procrastinations if providing OPI, respirators and test kits where probably partially related to allowing time for the cronies to catch up with the process of providing these on preference of well tried and tested companies. Sleazy incompetence or is it incompetent sleaze?
The same procrastination that was the hallmark of dealing with the first phase of the Sars Cov2 pandemic is happening again. Having had to enact a rather shoddy form of lockdown, having used the pandemic as a tool to transfer money to its cronies rather than look after its population, the hapless Johnson regime continues from one blunder to another.
Let me try this again. The basic way of dealing with a pandemic is to limit travel of possible infected people by introducing measures at major entry points, such as vigilant questioning visitors about symptoms, monitoring temperatures of those proposing to travel and stopping anyone with suspicion of infection, and QUARANTINE not voluntary self isolation. Meanwhile test and trace should not be wound down and sub relegated to Talk Talk rather than Do Do. But maybe Johnson thought that substituting Dido for Do Do will do the job.Interesting how little has happened in terms of firm proactive policy with regards to dealing with the pandemic since my last post. We are also now still talking about a no deal Brexit like a stuck record.
The Covid skeptics are not a unified tribe. At one extreme are those who deny the existence of the virus and who also think it is due to 5G and all that Bill gates injecting electronic tags with his evil vaccines. These can be safely ignored as they have little contact with reality. But there is also a lot of the population that genuinely have concerns, because of the conduct of the government and the inefficiency of dealing with this pandemic. At each step the government has messed up and when I started this forum in March, Johnson et al were trying to introduce the concept of herd immunity whilst saying they are prepared for the pandemic which was a blatant lie, as it transpires later with the care home deaths, the lack of PPE and general lack of preparedness. As a result some of the richest countries including US and UK suffered the worst effects of the virus and did not even suffer as badly economically. We are now in a mess and no wonder there are so many skeptic people. Even the role out of the vaccine with delay in the second dose was not handled properly.
But we must make a distinction between the pandemic and its realities and the scientific findings, and the political mishandling of the crisis and the opportunities the government used not only to increase centralized power but also to enrich their cronies with opaque and shady deals to provide PPE and the blatant privatization of track and trace which has never been run properly. Also having made so much fuss about control of our borders, there was no such control where it mattered most and when travelers entered this country bringing in the virus without any checks.In an article in Counterpunch, “The UK’s Pandemic Gets Worse”, Kenneth Surin summarises what went wrong with how the pandemic was managed in UK. The current variant is not only more efficient at being transmitted but is also more lethal. The NHS capacity, already below par
“An important consideration here is that the UK entered the pandemic with fewer staffed, funded ICU beds compared with other developed countries. Germany has 29 ICU beds per 100,000 population, the US around 25, the UK 6.6.”. and the shortfall is compensated for by cancelling other NHS activities such as routine surgery and by overworking the existing staff . Covid-19 related admissions are almost 38,000 today and the deaths are hovering over 1000 daily.
“The prime minister, Boris “BoJo” Johnson, let 17 days elapse between being alerted of the new variant and imposing a tough national lockdown.” That is true to the pattern of behaviour from the outset of this pandemic, delay lockdown despite advice from SAGE. The messaging is also often confused and there is little attempt at enforcement. International travel is not restricted.
“However, the biggest cause of the continuing transmission is almost certainly the fact that so many workplaces remain open. The government is unwilling to close non-essential workplaces.”So some covid sceptics are in a way right, the lockdown is not working but that is mainly because it has not been implemented properly and we have the worst of both worlds.
In a similar vein is a piece here. We need an overall goal that we want to achieve and then strategise to achieve it.
This is all very well but there seems a very wide interpretation of what social distancing, self isolation, quarantine and curfew mean. Moreover there is a very loose interpretation of these terms. The efficacy of proper isolation and quarantine depends to a high degree not on just on issuing loose instructions that are impractical and unenforceable. In the first lockdown there was less ambiguity about what it means. Shops were closed and streets were empty, but in the current lockdown this is far from the case in my experience. Also self isolation is nonsense. How do you ask someone who lives alone to self isolate when there is no official support system for those self isolating? How do those who have no source of income, self isolate and feed themselves. Then there are families in a flat for example. If someone gets the infection everyone will get it because it is impossible to self isolate in limited environments. The Tories in their mansions with several bathrooms might be able to manage. Then you come to enforcement, there is none and what there has been has been clumsy and rather selective, with politicians and others getting away with breaking their own rules.
This poor application of quarantine has meant that the measures were only partially effective, have to be done for longer and have caused more economic damage. No wonder the covid sceptics feel that lockdown has not done anything useful but lots of harm.
Then we come to test and trace. A very simple concept which is the bread and butter of public health and has been practiced for years. Why can we not have a local test and trace system successfully? Why farm it of to cronies who know nothing about public health. To this day there is no successful test and trace in this country.But above all there has been a lack of leadership and that is apparent in all of the action of this government. This lack of leadership has cost many lives.
For once I completely disagree with the WHO (for what it is worth) about Vaccine Nationalism, urging UK to halt or slow vaccination so that the rest of the world will catch up. As the burden of recorded case in the world is dominated by countries like US, UK Brazil and Mexico and France accounting for 60% of the total world cases, I think that it is a matter of urgency that these countries should go ahead full steam with vaccination to stem the number of cases and deaths and in turn also limit new mutations. Admittedly the problem with the data is that the true situation is probably not known in a lot of Africa, but I see no reason why for example Vietnam or Thailand or New Zealand, where the urgency to vaccinate is much less, should not wait.
SA: “For once I completely disagree with the WHO”
I disagree with them too. It’s highly counter-productive, putting people’s backs up against their organisation and 100% guaranteed to gain no cooperation whatsoever from our government. Not only has our country tested it, approved it and paid for it, we have actually invented one version of the vaccine and are producing it here. It’s rightfully ours.
Considering we also have the highest death rate in the world of any large country in the past month, it’s kind of hard to see why we should be shipping it off to the countries usually associated with hard luck – Chad has 118 dead, Liberia 84, the most populous African country Nigeria – less than 1600 fatalities out of over 200 million. Ethiopia – 2100 dead out of 110 million.
I mean, come on.
Maybe the point is that wealthy countries with highly mobile populations, which refuse to use social methods to control covid – well, maybe they shouldn’t get to hog all the vaccine.
But Clark this mobility has led to the multiplying mutations and will mean continuing to infect others. It really is a question of reducing the largest number of new cases.
