[abarro81]

Some clarity for business at least with a list of who must remain closed.

However for others wording varies between sources on whether they 'can' open or 'should' open. NB Legally, 'should' is a recommendation and not mandatory.

I read that as places like physios and sports massage people being able to open. Which is good for a man with a duff finger, but strikes me as rather surprising. Did I skip a sentence or two somewhere?

[SA Chris]

Some clarity for business at least with a list of who must remain closed.

However for others wording varies between sources on whether they 'can' open or 'should' open. NB Legally, 'should' is a recommendation and not mandatory.

As in "should open, as you won't get furlough pay any longer"? Let's see what the next announcement brings..

[tc]

Some much-needed clarification:

* 4 year olds can go to school, but university students who have paid for the tuition they haven’t had and the accommodation they aren’t living in, can’t go to university.

* A teacher can go to school with many 4 year olds that they are not related to, but can’t see one 4 year old that they are related to.

* You can sit in a park, but not tomorrow or Tuesday but by Wednesday that’ll be fine.

* You can meet one person from another household for a chat or to sunbathe, but not two people so if you know two people from another household you have to pick your favourite. Hopefully, you’re also their favourite person from your household or this could be awkward. But possibly you’re not. But as I can’t go closer than 2m to the one you choose anyway you wouldn’t think having the other one sat next to them would matter - unless two people would restrict your eyeline too much and prevent you from being alert.

* You can work all day with your colleagues, but you can’t sit in their garden for a chat after work.


* You can drive to other destinations, although which destinations is unclear.

* The buses are still running past your house, but you shouldn’t get on one. We should just let empty buses drive around so bus drivers aren’t doing nothing.

* It will soon be time to quarantine people coming into the country by air... but not yet. It’s too soon. And not ever if you’re coming from France because... well, I don’t know why, actually. Because the French version of coronavirus wouldn’t come to the UK maybe.

* Our youngest children go back to school first because... they are notoriously good at not touching things they shouldn’t, maintain personal space at all times and never randomly lick you.

* We are somewhere in between 3.5 and 4.5 on a five point scale where 5 is all of the virus and 1 is none of the virus but 2,3 and 4 can be anything you’d like it to be really. Some of the virus? A bit of the virus? Just enough virus to see off those over 70s who were told to self isolate but now we’ve realised that they’ve done that a bit too well despite us offloading coronavirus patients into care homes and now we are claiming that was never said in the first place, even though it’s in writing in the stay at home guidance.

* The slogan isn’t stay at home any more, so we don’t have to stay at home. Except we do. Unless we can’t. In which case we should go out. But there will be fines if we break the rules. So don’t do that.

Don’t forget...

Stay alert... which Robert Jenrick has explained actually means Stay home as much as possible. Obviously.

Control the virus. Well, I can’t even control my dogs and I can actually see them. Plus I know a bit about dogs and very little about controlling viruses.

Save lives. Always preferable to not saving lives, I’d say, so I’ll try my best with that one, although hopefully I don’t need telling to do that. I know I’m bragging now but not NOT saving lives is something I do every day.

So there you are. If you’re the weirdo wanting unlimited exercise then enjoy. But not until Wednesday. Obviously.

[webbo]

 

[petejh]

Some much-needed clarification:

* 4 year olds can go to a school system that their parents have paid tax towards, but university students who have paid for the tuition they haven’t had and the accommodation they aren’t living in, can’t go to university because 4 year-olds spend a few hours in schooland then go home to watch ceebeebies, rather than live full-time in shared accommodation with people from all over the country/world and don't tend to have parties and shag each other, although ceebeebies is still a thing.

* Teachers shouldn't go back to work because they would risk catching coronavirus. Lower-skilled workers can all die for all we care because they never paid attention in school and they probably bullied us.

* You can sit in a park, but not tomorrow or Tuesday but by Wednesday that’ll be fine because it follows that well-known concept of 'linear time' whereby events can be allocated to a point on a commonly-understood calendar system of days, weeks, months and years at any point in the past, present or future; and this can be used to communicate and co-ordinate the actions of mass populations and we can all use this well-accepted principle to navigate our lives. The alternative is we each operate by our own personal clock, I mean I mostly do anyway.. 

* You can meet one person from another household for a chat or to sunbathe, but not two people because if two teh nwhy not three or four or five right. So if you know two people from another household you have to pick your favourite. Or just alternate like sensible people might.

* You can work all day with your colleagues, but you can’t sit in their garden for a chat after work.. because you probably hate your colleagues and who the hell wants to sit in their garden.

* You can drive to other destinations.. although the new guidance, if you bother your arse to read it, states that you should check ahead to ensure planned destinations are open to the public - many areas have publicised that they aren't open so you wouldn't want to be 'that' dickhead and try to go to those places.

* The buses are still running past your house, but you shouldn’t get on one because bus drivers are among the workers facing the highest risk of being killed by having to go to work.. So we should just let empty buses drive around so bus drivers aren’t being killed by having to go to work, although we don't really know if bus drivers are being killed because they don't work on what the media tells us is  'the front line' so we aren't interested in them.

* It will soon be time to quarantine people coming into the country by air... but not yet. It’s too soon because it would have been, in the words of scientists advising on SAGE, a drop in the ocean of new cases compared to the exponential spread within the country and a drain on resources that would be better used elsewhere.. And not ever if you’re coming from France because... they have had a ban on incoming travel so France can't be easily used to travel through people trying to dodge the UK quarantine rule.

* Our youngest children go back to school first because... they are notoriously good at harming or killing themselves if left unattended at home while teenagers aren't, so much.

* We are somewhere in between 3.5 and 4.5 on a five point scale where 5 is all of the virus and 1 is none of the virus but 2,3 and 4 can be anything you’d like it to be really.. but if you're that bothered about it you can read the definitions, but anyway who the hell around here understands numbered scales that correspond to increasing severity?

* The slogan isn’t stay at home any more, so we don’t have to stay at home. Except we do. Unless we can’t. In which case we should go out. But there will be fines if we break the rules. So don’t do that. And definitely don't waste your life being a cock and not using your common sense.

FTFY

[tc]

Ta.
 

[Oldmanmatt]

Your missing the “as long as you maintain social distancing” thing though.

All sports can be played in some form or other within these guidelines. You could go on your own and use the local basket ball court or with a family member. Ditto footy, ditto climbing, ditto rugby etc. You couldn’t last week.

Sumo might be hard but other than that it’s all possible.

Seems to me that everyone is expecting some kind of individual risk assessment and plan writing up For them.

Footy.

With 2mtr distancing?

Team lined up at 2mtr intervals across pitch. “None shall pass!” (Did you see what I did there) and you’re down to shots at goal from the centre line...

I have been playing footy with the family all shutdown in the garden as i am lucky enough to have one big enough. ditto chucking rugby balls about. I can now got down the local field as long as its socially distanced, so you are wrong.


You make the assumption that it must involve a match where as you could just kick a ball between to people. A lot of kids are obsessed with footy but without a garden have not even been allowed to kick a ball, they can now. It obviously needs to be in an area not overly crowded.

At some point, you’ll realise I was making a joke about a possible format for socially distanced tactics; y’know, what with the leagues kicking off again soon (maybe)...

Another amusing image that popped into my head, was combing the sports of Football and Pole Vaulting. The pole would allow socially distanced tackling and allow players to pass each other (as long as the pole was greater than two meters). Probably end up looking like some Dantesque Chimera of Football, Snooker, Hockey and Field Athletics.*

I’d watch it just for the blood and horrific injuries.¹


*That wasn’t serious either.
¹ Neither was that.

This has been brought to you by Muppet, Plonker and Sons, speechwriters and strategists to Prime Minister Johnson...

[tomtom]

You’re too good for Bj.

[stone]

[tomtom]

Hows life in the Deloitte* snot emporium Stone?

*a guess

[Nigel]

Also interested in an update Stone. After the past few days I'm still left wondering what the government's public health strategy actually is - are we committing to test, trace, isolate, and if so are doing it now, or "sometime soon" like with border controls? The masses have their orders - "Stay Alert"; but what are they doing?

Also, had a cynical thought this morning. Given that we can meet one person outside but not two, the logic I can best make fit is that it is designed to shut down any potential protest. Or if not designed that way, it helpfully has that effect.

[stone]

Hows life in the Deloitte* snot emporium Stone?

*a guess

Hi, I only know about Deloitte involvement via the media. On time sheets it is "Department of Health Alderly Park". On other stuff it is "Lighthouse Labs Alderly Park hosted by Medicines Catapult".

I guess Deloitte would be involved in the overall logistics of getting the swabbing done and getting the samples sent to us. I think though the vans arriving with samples are DHL and they get unloaded by Army people. It is Army people in uniform who walk in with stacks of samples.

It is great for my peace of mind to be able to get on with some testing . It is a very friendly, happy, upbeat place to work. I'm not the only Sheffield climber there.  It is a zero-hours type arrangement and it was a case of getting an email at 7pm telling us whether or not to come in at 7:30 am the following day but now we get several days notice (I was off yesterday and today, after five days on through the weekend, and then I'm on for the rest of this week and weekend).

There was a lot of training going but that seems to have quietened down with enough people to make use of the space. They might have an extra shift (after 8pm) introduced though I guess.

On the whole I can just turn up and get on with it. Last Tues though barely any samples turned up so we were all sent home and the following shift was cancelled. The other glitch is that the sample tubes come in a bizarre array of shapes and sizes that demands innovation in handling/racking etc.  When I started many of the samples were arriving in leaked tubes that had to be voided. That seems to have been largely sorted now. Many samples still arrive with the barcodes  wrapped around the tube such that they have to be peeled off to scan them though.

I have a totally worm's-eye-view of it all. I have no idea why there are the reported multiple-day delays people are reporting for getting test results back. As far as I can see we get through the samples that are sent to us within a day. I suppose there must be unfathomable delays either in getting the samples to us or getting the test results back to the people tested.

I read that in South Korea people can turn up to get swabbed with ample availability and they get the results back in seven hours. That is what we need here if we are to get test-trace-isolate working and get to grips with the crisis.

You wrote before that a friend of yours is a professional in an NHS COVID19 testing lab. I read something (now a few weeks old) from their professional body that seemed exasperated that the testing wasn't all being done by the NHS and PHE labs. I really hope that that is now resolved and that people like me are helping the overall effort rather than unwittingly being party to some grand Tory outsourcing fiasco.

[tomtom]

Thanks for the update Stone - thats really good - and interesting to hear. Good to get out of the house and do something to help too (wish I could)...

In Wuhan - according to the WHO reports they had hospitals/clinics where if you were suspected you turned up were tested - and then waited there for the 4 hours it took to get the results back. If positive you stayed - if negative you went home. Part of the testing also included a CT scan. I've read that in UK hospitals if suspected CV cases are admitted they first chest x ray them as its quicker than waiting for a test (and we don't have many ct scanners).

We've not heard from our friends for a while - hope they're OK. Both normally work in labs in MRI (Manchester Royal Infirmary) and were moved - all hands to the pump - to the CV19 testing bits.. 

[ali k]

Also, had a cynical thought this morning. Given that we can meet one person outside but not two, the logic I can best make fit is that it is designed to shut down any potential protest. Or if not designed that way, it helpfully has that effect.

You could still just ‘happen to meet’ a load of other people in the street, purely by chance of course, all carrying similar placards. “Well I didn’t know all these other people were going to be here guv’na”.

Although saying that, given Johnson seems to have been won over by the hawks and they’re now falling over themselves to push people back to work despite no effective test-trace-isolate strategy in place the most obvious way to protest would be a peaceful one at home watching Midsomer Murder repeats. You really tried to get child care of course, but with no luck. It’s just a good job Boris agrees that’s “a barrier to work” and “all reasonable employers will understand”. He’s got our backs on that one 

[stone]

In Wuhan - according to the WHO reports they had hospitals/clinics where if you were suspected you turned up were tested - and then waited there for the 4 hours it took to get the results back. If positive you stayed - if negative you went home. Part of the testing also included a CT scan. I've read that in UK hospitals if suspected CV cases are admitted they first chest x ray them as its quicker than waiting for a test (and we don't have many ct scanners).

A friend who's a doctor on the COVID19 ward in Sheffield told me that they have been able to get their patients' test results done by the hospital's own lab with a 6hr turnaround (that's similar to the process time at Alderly Park).

Four hours is extremely impressive if those Wuhan tests are RT-PCR tests. That speed would be like just processing one sample through with no delays anywhere I'd guess. It takes me ninety minutes to get a batch of ninety sample tubes scanned in and the samples pipetted into a 96well plate ready for the first robot. The samples are double bagged and it's all done in a virus containment hood which makes it all a faff. There is also someone up stream opening the boxes that the samples come in. 

It is stunning that they have that availability of CT scanners in Wuhan. I remember back when I had lymphoma, I had an eight week wait for a CT scan after I had finished chemo and the result was that I still had a residual mass that needed some unplanned radiotherapy.

I also read that in Wuhan they had extracorporeal membrane oxygenation machines for patients who couldn't survive on a ventilator. I think in the UK we have wallowed in the idea that we should offshore everything such as making smart phones etc to places such as China and Korea whilst we took the elevated roles such as composing adverts for phones or trading derivatives of stocks of phone companies etc. Those nurtured capabilities haven't been a lot of use against the virus.

But what really galls me is that we do have vastly more of the needed expertise than has been made use of in this crisis. What has really failed has been coordination. The government has been very effective at shutting things down but utterly rubbish at empowering people to do what they want to do to sort it all out. When we look back at this, I think that is what we really have to do soul searching about. How and why does that all work in other countries but not here? We had 750k people sign up to "help the NHS". Evidently our government was only up for setting up a sign-in website and not for anything beyond that. Perhaps it is a reluctance to delegate. The COVID19 testing in South Korea and Germany was delegated down to local labs who volunteered to convert to do it. In the UK there was a massive desire from the ground to join in something like that but it wasn't allowed to happen. Similarly with contact tracing, the UK has thousands and thousands of people clued up and keen to get contact tracing apps working. But we don't have anything working even now. The 750k people who volunteered to help the NHS would no-doubt have included many (ie tens of thousands at least) who would have been up for Chinese-style "shoe-leather" contact tracing. But nothing gets done.

[Nigel]

I also read that in Wuhan they had extracorporeal membrane oxygenation machines for patients who couldn't survive on a ventilator. I think in the UK we have wallowed in the idea that we should offshore everything such as making smart phones etc to places such as China and Korea whilst we took the elevated roles such as composing adverts for phones or trading derivatives of stocks of phone companies etc. Those nurtured capabilities haven't been a lot of use against the virus.

But what really galls me is that we do have vastly more of the needed expertise than has been made use of in this crisis. What has really failed has been coordination. The government has been very effective at shutting things down but utterly rubbish at empowering people to do what they want to do to sort it all out. When we look back at this, I think that is what we really have to do soul searching about. How and why does that all work in other countries but not here? We had 750k people sign up to "help the NHS". Evidently our government was only up for setting up a sign-in website and not for anything beyond that. Perhaps it is a reluctance to delegate. The COVID19 testing in South Korea and Germany was delegated down to local labs who volunteered to convert to do it. In the UK there was a massive desire from the ground to join in something like that but it wasn't allowed to happen. Similarly with contact tracing, the UK has thousands and thousands of people clued up and keen to get contact tracing apps working. But we don't have anything working even now. The 750k people who volunteered to help the NHS would no-doubt have included many (ie tens of thousands at least) who would have been up for Chinese-style "shoe-leather" contact tracing. But nothing gets done.

Nailed it in those two paragraphs Stone. On both angles - that despite talking a big talk most politicians, especially of the right, view productive work as something that makes money, rather than something that makes things. Things gets offshored and we become a nation that can't make enough waterproof gowns. And then the obsession with centralising things rather than using alternative options. I actually don't have a problem with centralisation in theory as it can be a more efficient way to do things. But only if you are organised and put the hours in. Those times are behind us it appears. Currently gov seem unable to organise an orgy in a brothel. And the only alternative option they consider is more outsourcing. I think the NHS volunteers thing shows that PR takes precedent over actually doing anything.

[ali k]

It looks like a return to a large scale decentralised test-trace-isolate strategy before lockdown measures are eased is one of the key recommendations of the ‘Independent SAGE’ group.

[Nigel]

Yep. From the Guardian live blog:

In a report being published today, the group warn that simply ensuring the NHS is not overwhelmed is “counter-productive” and “potentially dangerous”. Without strong measures to suppress the spread of infections “we shall inevitably see a more rapid return of local epidemics and face the prospect of further partial or national lockdowns,” the authors write.

The report, which includes 19 key recommendations, will be sent to Downing Street, Patrick Vallance, the chief scientific adviser who co-chairs Sage, the first ministers in Wales, Scotland and Northern Ireland, and Jeremy Hunt, the chair of the Health Select Committee.

The experts call on ministers to reverse the 12 March decision to abandon efforts to test, trace and isolate cases of Covid-19 and replace the existing centralised testing approach, which relies heavily on the private sector. In its place, the group call for a decentralised strategy that puts GPs and local health teams at the heart of the outbreak control. The report states that the “over-dependence on outsourcing” is unsustainable.

Note last paragraph = what Stone said.

[Nigel]

Hancock added: "Some of our most vulnerable people live in care homes and yet only around a quarter of the deaths that have happened have been in care homes. That’s much lower than most international comparators."

Er, hang on!

[ali k]

Hancock added: "Some of our most vulnerable people live in care homes and yet only around a quarter of the deaths that have happened have been in care homes. That’s much lower than most international comparators."

Er, hang on!

That wouldn’t be one of our most senior govt ministers indulging in a spot of double standards would it? Surely not.

[mrjonathanr]

It looks like a return to a large scale decentralised test-trace-isolate strategy before lockdown measures are eased is one of the key recommendations of the ‘Independent SAGE’ group.

That is why David King has set it up really, isn't it? That and the fact that full public buy-in requires transparency. We aren't doing this though. My current guess is a second wave in July.

[stone]

Yep. From the Guardian live blog:

In a report being published today, the group warn that simply ensuring the NHS is not overwhelmed is “counter-productive” and “potentially dangerous”. Without strong measures to suppress the spread of infections “we shall inevitably see a more rapid return of local epidemics and face the prospect of further partial or national lockdowns,” the authors write.

The report, which includes 19 key recommendations, will be sent to Downing Street, Patrick Vallance, the chief scientific adviser who co-chairs Sage, the first ministers in Wales, Scotland and Northern Ireland, and Jeremy Hunt, the chair of the Health Select Committee.

The experts call on ministers to reverse the 12 March decision to abandon efforts to test, trace and isolate cases of Covid-19 and replace the existing centralised testing approach, which relies heavily on the private sector. In its place, the group call for a decentralised strategy that puts GPs and local health teams at the heart of the outbreak control. The report states that the “over-dependence on outsourcing” is unsustainable.

I totally agree with putting GPs at the heart of outbreak control. A Sheffield GP was on TV who had set up local shoe-leather contact tracing and was saying that the same could be done in parallel throughout the country. I'm wondering though about the wisdom of reversing the centralisation of testing. I guess a lot depends on whether by "testing" they mean swabbing the people or analysing those samples. People should be swabbed wherever is most convenient for them to ensure they get it done promptly. Regarding analysing samples, the huge advantage of taking the South Korean/German "Dunkirk small ships" approach was that already existing teams of people were able to just get going from the outset. The UK Lighthouse labs have entailed converting offices into labs and recruiting and  vetting the staff. That caused many weeks delay. But that is now water under the bridge.

The only remaining advantage of decentralised sample analysis would be if logistics were more agile with decentralisation. That might, but perhaps need not necessarily, be the case. It only takes a few hours to drive from anywhere to one of either Milton Keynes, Alderly Park or Glasgow (the "mega-lab" sites). So delays of several days (as I've heard of) are not due physical distance. They are down to other screw ups. I suppose a lot of the decision hinges on what is being done with the testing. Perhaps some people (such as some customer-facing key workers) etc ought to be tested every week or so. That perhaps could be done well in a centralised mega-lab. Perhaps test-trace-isolate strategies though need extremely rapid testing where every hour counts a tremendous amount. Those might be best met by innovative point-of-care testing technologies rather than RT-PCR. Perhaps though an RT-PCR back-up test might still be wanted. A centralised lab might be suitable for such back-up testing.

Another possible advantage of decentralisation is that it could provoke more technological innovation. Being centralised locks things into a fixed way of doing things. Obviously a given test needs to follow a validated Standard-Operating-Procedure. But if many different labs were doing it, they would be developing and validating improved approaches as side projects. Methods such as using second generation sequencing, CRISPR etc etc may well supersede the RT-PCR test method.

Above all, I'd want to know what causes the UK delays and to talk to people doing this in South Korea, China etc if I were deciding. You'd hope that those deciding are up on that but I really wonder and doubt it.

[tomtom]

Also the transfer of information Stone. Many complaints that CV19 results from centralised (provatised?) system are not being forwarded to GPs or updating patient records... I suspect this would not be such an issue if testing had been devolved.

[sdm]

I have a totally worm's-eye-view of it all. I have no idea why there are the reported multiple-day delays people are reporting for getting test results back. As far as I can see we get through the samples that are sent to us within a day. I suppose there must be unfathomable delays either in getting the samples to us or getting the test results back to the people tested.

Based on my experience, I think the problem is likely to be the logistical delays of getting the tests to the patients and on to the testing centres and then the same delays getting the results back again.

I'm taking part in the antibodies testing study. Here is my anecdotal experience of being tested:

20th April: I am contacted to urgently arrange an appointment to be tested. Requested to call at 9am. 9-12: call centre fails to cope with demand. No queueing system, just an engaged tone. 12-14: call centre offline. 14-17: engaged tone.
21st April: I finally get through to a robot, where I can request a callback (they had everybody's contact details from the start, why were we ringing them?)
24th April: I get my callback. Testing appointment booked for 26th April. Nurse will call ahead to confirm the time.
26th April: The nurse never turned up or contacted me.
27th April: I rang up to find out whether I needed to rearrange. Took 4 hours to get through to a robot to request another callback.
29th April: They called me back: apologised for the missed appointment, blamed an admin error. Someone would call me back to rearrange but she couldn't speculate as to when.
1st May: Called back by someone better informed: He admitted that the reason they missed my appointment and the reason why nobody had yet rearranged was that the Midlands depot had no testing kits. They were still awaiting their first delivery. I would be contacted ASAP when tests were able to commence. He couldn't give a timeframe.
10th May: I am contacted to rearrange and am finally tested. I discussed with the nurse who said it was his first day of being able to conduct any tests. He had received zero communication throughout on when the tests would be available. He went in to work each morning expecting to begin testing only to find out that he was not going to be testing that day.
12th May: I contacted my doctor to find out whether they had received my results yet. They were not aware of the study nor that results would be issued to them rather than directly to participants. During my test, the nurse had confirmed that he had already tested many people that day from my surgery (he now knew the surgery contact details by heart). The sole doctor is going to have to interpret all of these results before he can relay them to participants. It would be good if he was at least aware of this additional workload.

Similar to PPE, it is clear that the infrastructure and communication is inadequate at almost every stage of the supply chain. The bottle necks are not the preparation or testing in the lab.

We can rattle on about our "capacity" to test x number of people per day but it is completely irrelevant unless we have the logistical capacity along the entire chain from booking the test all the way through to communicating the results.

I hope these delays and confusions are because more urgent cases are being prioritised over volunteers taking part in an academic study to improve understanding but it does not inspire confidence.

[winhill]

Some clarity for business at least with a list of who must remain closed.

However for others wording varies between sources on whether they 'can' open or 'should' open. NB Legally, 'should' is a recommendation and not mandatory.

As in "should open, as you won't get furlough pay any longer"? Let's see what the next announcement brings..

Apparently an extension of the furlough period to October.

https://www.bbc.co.uk/news/business-52634759