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COVID-19 and the state of politics (Read 30435 times)

SA Chris

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It wouldn't surprise me if families of healthcare workers who die bring class action suit against the NHS if PPE provided is shown to be inadequate?

Nigel

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What I really donít understand is how working with inadequate PPE isnít a breach of H+S regs?

I know that guidance was recently revised down in the case of PPE but surely there are still breaches for NHS and care home staff ?

I asked this earlier in the thread - report below:

In the first instance, given this is a SARS-type virus, if the government are not providing health care workers *all* of the PPE listed in section 6 of the following HSE link then surely they are in breach of their own HSAW Act? Do journalists ever ask whether the gov thinks it is complying with its own laws? I don't watch the briefings any more but I doubt it. If they've let themselves off it via the new coronavirus bill it would still be good to know:

https://www.hse.gov.uk/biosafety/diseases/sars.htm


The HSE doc looks to have been produced following SARS-01 in 2003. Section 6 details the precautions to be taken by healthcare workers "until the cause and route of transmission are known". They include FFP3 masks, long sleeve fluid proof gowns, eye protection, latex gloves. Looks a clear breach to me. I suppose the gov could argue that the cause and transmission routes are now known and they can downgrade the PPE to suit. But as I said earlier, a private company in a similar situation of dealing with a load of employee deaths would be explaining that decision in court. Saying "the right PPE was in the post" would not cut it.

petejh

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Haven't read the replies up thread but just a musing - does anyone posting here actually KNOW - not have anecdotal evidence or using media reports as evidence - firstly what PPE is or isn't being worn in different areas of different hospitals (it's not a blanket policy in all areas of hospitals), and secondly what their actual stock of PPE is.

A small example which isn't meant to prove or disprove anything (just a bit of anecdote..): we donated 50 FFP3 masks, 100 tyvek overalls and 50 pairs of eye protection to Alder Hey hospital last Friday, as a friend's wife who works there lets us know they were short on stock and they were starting to take adult covid patients.
I was told the policy there is staff wear masks all the time even in areas without covid patients, as a way to prevent them touching their faces.. Make of that what you will but if true I don't think that is an effective use of a limited potentially life-saving PPE resource.

One doctor quote in a BMA report: 'ĎWe are being asked to risk our lives and our loved ones' lives, in flimsy paper masks and plastic aprons. I don't know if I can do it. I just don't know if I can. I don't think it is fair to expect this of us. I am terrified. How can this risk to practitioners, other patients, practitioners' families be justified?

Emotive stuff. But an FFP3 mask is the correct respiratory PPE, and it is indeed a 'flimsy paper mask'. Whether the doctor works in an area which requires visors isn't made clear, nor whether he has one.

All I mean by the above is from what I can tell it isn't clear to us or the media who's *really* not got access to life-saving PPE they *need*; who's not got access to PPE they'd *like*; and who's making noise. I think the truth will be a combination. That isn't meant to suggest we shouldn't be discussing it, just with some circumspection of what's said in media reports especially.
« Last Edit: April 08, 2020, 11:09:22 am by petejh »

Nigel

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Firstly, well done for donating the PPE.

On the rest, fair enough, we don't know for sure in the detail you quote. As always I am circumspect about media reporting as a rule! But I would take that as an argument for the media to do a better job of finding out for us. Investigative journalism would be useful on this.

Anecdotally I know GP's who were still issued only a surgical mask in middle of last week. I would guess they are FFP-zero!

Last week my nextdoor neighbour, and A&E doc, had no FFP3 mask at all as the stock had been all used up in the process of face fitting other doctors on the previous shift. So he was unprotected, and couldn't be face-fitted. He was told more would arrive, sometime soon.

Just those anecdotes are an obvious enough failing. The fact NHS workers are contracting it, and dying, is telling enough. That shouldn't happen at work.

mrjonathanr

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My thanks therefore to Toby and other NHS and social care staff for everything they are doing to care for people in what must be a very worrying environment.

petejh

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Nigel, regards your point on breach of HSE regs. Infection by coronavirus is a RIDDOR-reportable event. Reg 6 and reg 9 (for fatalities).

HSE guidance says FFP2 masks are considered suitable PPE if P3 masks are unavailable, as these are equivalent of N95 masks which are the standard recommended by WHO.
Eye protection required where risk of splashing from 'aerosol generating procedures'. I.e. sticking a tube down someone.

Working in areas where 'aerosol generating procedures' are being done requires masks/eye protection. Guidance from HSE seems pretty clear. I imagine there's room for interpretation of where the physical boundaries of those areas begin and end.

https://www.hse.gov.uk/news/face-mask-equivalence-aprons-gowns-eye-protection-coronavirus.htm
« Last Edit: April 08, 2020, 01:18:32 pm by petejh »

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A nursing home tragedy:

https://www.theguardian.com/world/2020/apr/08/canadian-nursing-home-reels-from-death-of-half-its-residents-bobcaygeon

Plus John Crace's political sketch. After saying nice things about a couple of cabinet ministers last week, this is really back to sticking the knife in:

https://www.theguardian.com/politics/2020/apr/07/leadership-jim-but-not-as-we-know-it-with-captain-raab-on-bridge

« Last Edit: April 08, 2020, 02:13:40 pm by Offwidth »

Nigel

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Eye protection required where risk of splashing from 'aerosol generating procedures'. I.e. sticking a tube down someone.

https://www.hse.gov.uk/news/face-mask-equivalence-aprons-gowns-eye-protection-coronavirus.htm

Many thanks for the link Pete, informative. 

Your link had another link within to this https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/personal-protection-equipment-letter-28-march-2020.pdf which is informative in very clear language about the PPE health care workers *should* have in different settings.

In light of the current lack of PPE and HSE discussion, this has been raised today by the Royal College of Nursing in a letter to the Parliamentary Health Committee. Below copy-and-pasted from Guardian Live blog as I couldn't find an actual full story on it:

Quote
Actions to mitigate PPE distribution is regarded by our members to have been too slow and not transparent.

Public commitments have not translated into increases in consistently deployed and accessible stocks of adequate PPE.

Without adequate and proper PPE, nursing staff are putting their own lives, the lives of their families and patients, at risk. This situation is unconscionable.Ē

A lack of PPE and hand sanitiser is particularly acute for nurses in GP surgeries and care homes, the RCN added. The RCN said that insufficient and inadequate PPE means health and care employers are breaching statutory obligations.

The union said it had written to the Health and Safety Executive calling for intervention.

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Sadly even more care home deaths

https://www.bbc.co.uk/news/uk-england-beds-bucks-herts-52175891

Plus a row breaks out as the EU's 'most senior scientist' resigns over the EUs covid 19 response

https://www.theguardian.com/world/2020/apr/08/eu-most-senior-scientist-mauro-ferrari-resigns-handling-coronavirus-crisis

 
« Last Edit: April 08, 2020, 05:53:13 pm by Offwidth »

galpinos

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Haven't read the replies up thread but just a musing - does anyone posting here actually KNOW - not have anecdotal evidence or using media reports as evidence - firstly what PPE is or isn't being worn in different areas of different hospitals (it's not a blanket policy in all areas of hospitals), and secondly what their actual stock of PPE is.

As Toby said, it actually very much depends on the Trust. My wife works in two hospitals, both run by different trusts. She is an oncologist so giving cancer treatment to patients with Covid, not treating v.ill Covid patients. One has a specific covid ward with a PPE room, in which when going from a non-Covid to Covid area, you have to go through the PPE room  where you can get masked up etc and there is plentiful PPE stock there. It's a good system that all the staff are happy with. The other has a lot less defined system and the PPE is spread around the hospital (which is comparably massive and also is dealing with patients who are in their solely for Covid) so it's more a case of grab the PPE when you can and hang onto it.

I imagine the scenario is a big London hospital is probably very different to a regional DGH that is suddenly overrun and is very different again for people like Toby who are out "in the community".

TobyD

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Haven't read the replies up thread but just a musing - does anyone posting here actually KNOW - not have anecdotal evidence or using media reports as evidence - firstly what PPE is or isn't being worn in different areas of different hospitals (it's not a blanket policy in all areas of hospitals), and secondly what their actual stock of PPE is.

As Toby said, it actually very much depends on the Trust.

Thanks Pete, and Nick, we have a community hospital with virus patients in side rooms, and at the moment doing emergency domiciliary visits usually for admission avoidance or discharge support.  Basic surgical mask for either, although as far as I know for community work we got a box of about 25 for a team of 15-20. Ordinary gloves and ordinary aprons. Most worried really about uniform ie in community you basically have to strip off somewhere,  change, bag the uniform and wash it immediately at home as hot as possible. 
The worst thing has been that what we're told to do for different categories of patients has changed so many times,  it leaves you very uncertain that there's much real evidence behind whatever is in place.


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seankenny

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https://www.thelondoneconomic.com/politics/mps-given-an-extra-10000-to-work-from-home/09/04/

Irksome??

If you've gone to your MP to ask about help with a late universal credit payment, you might want them to have a functioning remote office with staff who have the equipment they need.

gme

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Giving them all 10k seems a bit stupid, suggest allowing tthem to claim for additional expenses would be fair though.

Its cost us a lot to get all our staff working from home. Most of our staff dont have laptops so we had to buy a lot of them (at stupid prices as well) to get them up and running from home. Ditto phones, we have a VOIP system at work so now asking everyone to use mobile phones to make calls so will be stuck with a bill from every person.

Add in a few other bits and the cost of our IT company setting everyone up and dealing with far more issues i can see how its easily going to cost us over a grand for most people.

I would however have expected most MPs to have facilities at home already and laptops etc.

Nigel

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Not sure what to make of the extra £10K for MPs. All I can say is wouldn't it be great if other key workers could boost their pay so easily?

Dominic Raab at today's briefing dodged answering a question about increasing NHS workers pay - "there will be a moment when we look at formally recognising all those on the front line who have done so much to pull us through this very difficult period for our country." he said. I guess if you're an MP, that moment is now. Some people are more equal than others. I also wonder if his opinion of British workers as "...among the worst idlers in the world" (from Britannia Unchained) is still unchanged, given his numerous paeans to the NHS during the briefing?

In other news yesterday the health secretary issued a plea to biotech businesses to develop an antibody test that works. 6 days after promising we would get to 100,000 tests a day. I'm not an expert but those two things look to have been done in the wrong order, to the layman. Still hope we manage it nonetheless.

ali k

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Dominic Raab at today's briefing dodged answering a question about increasing NHS workers pay - "there will be a moment when we look at formally recognising all those on the front line who have done so much to pull us through this very difficult period for our country." he said.

I predict itíll be a pin badge or certificate with some fun cliparts added to make it look fancy.

chris j

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Given all the fuss and threats from councils and the police about sunbathers and frisbee throwers in parks i don't understand why more of a stink isn't being raised about the number of call outs for house and street parties.

Twice as many calls for parties as incidents in parks,  and its hard to imagine Manchester is exceptional. Much more of a mockery of the spirit and letter of the restrictions than many of the other incidents that the police have been enthusiastically shaming online.

https://www.bbc.co.uk/news/uk-england-manchester-52221688

TobyD

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Given all the fuss and threats from councils and the police about sunbathers and frisbee throwers in parks i don't understand why more of a stink isn't being raised about the number of call outs for house and street parties.

Twice as many calls for parties as incidents in parks,  and its hard to imagine Manchester is exceptional. Much more of a mockery of the spirit and letter of the restrictions than many of the other incidents that the police have been enthusiastically shaming online.

https://www.bbc.co.uk/news/uk-england-manchester-52221688

There was an interesting statistical analysis of one of the stories about breaking the lockdown on More or Less this week  (search for it on BBC sounds) that the numbers in one London park reported as excessive actually amounted to less than 5 per acre.

There certainly have been some selfish people thinking that they are more important than trying not to kill more people but I'd guess many of these reports are sourced by journalists who are mostly at home from Twitter rumours and second hand evidence. Most people I've seen are broadly playing by the rules, however I've obviously not been out much so what would I know?

I do think that if would probably have made policemen's lives easier if they had more power to punish people who are blatantly flouting the lockdown, their jobs must be incredibly difficult at the moment. 

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The Guardian today have an item on care homes,  including information from one of the big UK care home providers. Worrying.

https://www.theguardian.com/world/2020/apr/09/we-havent-had-time-to-grieve-care-homes-struggle-as-covid-19-deaths-rise

Duma

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Given all the fuss and threats from councils and the police about sunbathers and frisbee throwers in parks i don't understand why more of a stink isn't being raised about the number of call outs for house and street parties.

Twice as many calls for parties as incidents in parks,  and its hard to imagine Manchester is exceptional. Much more of a mockery of the spirit and letter of the restrictions than many of the other incidents that the police have been enthusiastically shaming online.

https://www.bbc.co.uk/news/uk-england-manchester-52221688

Agreed, it has bothered me the way some obviously very low risk activities like sunbathing are getting shamed when houseparties are clearly a much more likely vector for spread. I hope at least the hosts will be charged.

Re public behaviour, our house overlooks a bit of grass with a view across the city, and I've been impressed with how few folk have taken the piss - there's been only one obvious group of lads since the lock down, and they moved on after half an hour.

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tomtom

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An article from Byline Times looking at government policy on covid 19.

The who? The site had all sorts of fake news/bullshit claxons going off in my head... Happy to be wrong...

abarro81

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Presumably we're going down one of two roads - either
1) A gradual herd immunity approach, where we slow it down enough to build NHS resources and hopefully work out what drugs make you less likely to get really ill when you get it... or...
2) full-on reduction in numbers then huge amounts of testing and contact tracing with (enforced?) isolation of those who've been in contact with recent cases

If we're going for 2 then our lockdown is shit and should be way more rigorous (otherwise lockdown will have to be WAY longer). Our approach looks more like 1 than 2 right now, so presumably we should expect what the article seems outraged about. Am I missing something?  :shrug:

Do we think that countries are coordinating behind the scenes on 1 vs 2? It would seem dumb to have half the world do 1, half the world do 2, and then have to cut the world in half in terms of allowed travel. If that happens I really hope we pick the same option as France and Spain  ;D

Oldmanmatt

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Presumably we're going down one of two roads - either
1) A gradual herd immunity approach, where we slow it down enough to build NHS resources and hopefully work out what drugs make you less likely to get really ill when you get it... or...
2) full-on reduction in numbers then huge amounts of testing and contact tracing with (enforced?) isolation of those who've been in contact with recent cases

If we're going for 2 then our lockdown is shit and should be way more rigorous (otherwise lockdown will have to be WAY longer). Our approach looks more like 1 than 2 right now, so presumably we should expect what the article seems outraged about. Am I missing something?  :shrug:

Do we think that countries are coordinating behind the scenes on 1 vs 2? It would seem dumb to have half the world do 1, half the world do 2, and then have to cut the world in half in terms of allowed travel. If that happens I really hope we pick the same option as France and Spain  ;D

Reckon itís 1.

2 seems implausible. We can build capacity, itís been demonstrated that we can finance option 1, if the political will exists and we deal with the knockons later.
Itíll hurt but....

On the other hand, international travel might be slow to recover, if ever to previous norms.

 

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