Coronavirus - how is it/has it affected you?

[MegaSteve]

Finally got to attend a clinic I was originally booked for in April... Been two cancellations in the interim... Nursey explained she'd normally be 'juggling' four folk at any one time but with distancing it's now strictly one at a time... Fortunately, for me, no fault found but I am sure delays in service will be sadly impacting on others...

 

[Backache]

But for an exposure to be adequate to merit isolation, there needs to be prolonged (15 mins) contact and/or close contact (1m or less), and if you were both wearing masks, in a supermarket, say, the risk is negligible.

As far as I know contact tracing works by taking a proper history from the infected person to determine whether there was significant risk to infection in other people , which includes length of time distance and other precautions taken . Only then is a message sent to self isolate . At least that's how it works in Scotland, think its usually by phone rather than test as well.

 

[Ethan]

As far as I know contact tracing works by taking a proper history from the infected person to determine whether there was significant risk to infection in other people , which includes length of time distance and other precautions taken . Only then is a message sent to self isolate . At least that's how it works in Scotland, think its usually by phone rather than test as well.

That is how proper contact tracing is done from the index case, it is indeed critical to establish if there has been enough time/proximity for exposure, but in England, if you get a notification from NHS Test and Trace that you have been ID'd as a contact, you are not given any information on what the exposure was or where it occurred. I don't think that is adequate for 2 weeks isolation.

 

[Backache]

That is how proper contact tracing is done from the index case, it is indeed critical to establish if there has been enough time/proximity for exposure, but in England, if you get a notification from NHS Test and Trace that you have been ID'd as a contact, you are not given any information on what the exposure was or where it occurred. I don't think that is adequate for 2 weeks isolation.

That is the same every where if the first case wishes to maintain confidentiality. It has to be the case , you either have to trust the system or not, there will always be errors but unless you can determine that the errors are large and systematic, casting doubt on the system without sufficient evidence is unhelpful to public health.

 

[Ethan]

That is the same every where if the first case wishes to maintain confidentiality. It has to be the case , you either have to trust the system or not, there will always be errors but unless you can determine that the errors are large and systematic, casting doubt on the system without sufficient evidence is unhelpful to public health.

I know about contact tracing, I was a public health doctor, and have worked on outbreaks, but the problem is that in most contact tracing scenarios, you identify possible cases then test them, for example nasal swabs in meningitis, other swabs in STIs, and isolation is not necessary in all such cases.

In this one, despite close contacts being identified as high risk, they don't test, which is even worse where there are asymptomatic cases. Therefore you need to verify the plausibility of each case and the index case may or may not be reliable. Each contact should be able to know more than 'you have been ID'd, you can't go outside the house for 2 weeks, sorry can't tell you any more'. There is no confidentiality breach if you are told that the contact was with a case in Tesco or The Dog and Duck last Tuesday. You don't have to give the name and address.

 

[Lord Tyrion]

I do wonder how many people are giving correct details for track and trace. I always have but I understand why some may not. Each place I have been to, mainly golf club bars, I have been nowehere near any other table. Most ask for a time you arrive, few ask you to put down when you leave. I could have left a room 10 minutes before an infected person arrives and be rung still. I could be 20m away from an infected person and be rung still.

The phone app talked about being within 1m of an infected person for 15 minutes or more. Our system has us in the same room, no matter the size of room, and at an approximate time. That is hugely loose and I am not keen to isolate for two weeks based on that type of set up. I ultimately would but through gritted teeth and I get why some would not.

 

[Backache]

I know about contact tracing, I was a public health doctor, and have worked on outbreaks, but the problem is that in most contact tracing scenarios, you identify possible cases then test them, for example nasal swabs in meningitis, other swabs in STIs, and isolation is not necessary in all such cases.

In this one, despite close contacts being identified as high risk, they don't test, which is even worse where there are asymptomatic cases. Therefore you need to verify the plausibility of each case and the index case may or may not be reliable. Each contact should be able to know more than 'you have been ID'd, you can't go outside the house for 2 weeks, sorry can't tell you any more'. There is no confidentiality breach if you are told that the contact was with a case in Tesco or The Dog and Duck last Tuesday. You don't have to give the name and address.

With STI's , meningitis etc there is not a latency period where testing is useless so you can test them there and then, with covid testing in the incubation preiod is pointless, which is why they are required to isolate rather than test.
Unless you know the circumstances of why the text does not specify the nature of the contact you cannot possibly determine the reasons for confidentiality.

 

[road2ruin]

I do wonder how many people are giving correct details for track and trace. I always have but I understand why some may not. Each place I have been to, mainly golf club bars, I have been nowehere near any other table. Most ask for a time you arrive, few ask you to put down when you leave. I could have left a room 10 minutes before an infected person arrives and be rung still. I could be 20m away from an infected person and be rung still.

The phone app talked about being within 1m of an infected person for 15 minutes or more. Our system has us in the same room, no matter the size of room, and at an approximate time. That is hugely loose and I am not keen to isolate for two weeks based on that type of set up. I ultimately would but through gritted teeth and I get why some would not.

I must admit I don’t think I would isolate for 2 weeks. It’s a huge ask and I would want to be sure that it is warranted rather than an airy fairy, you may have been in the same room as someone for 30 seconds and didn’t come within 10 metres of that person. If it ended up being that loose you could isolate for a couple of weeks and then be caught again if you were especially that unlucky.

As above though, I don’t have any issues following guidelines and isolating but only if there is definite evidence that it is required.

 

[Ethan]

With STI's , meningitis etc there is not a latency period where testing is useless so you can test them there and then, with covid testing in the incubation preiod is pointless, which is why they are required to isolate rather than test.
Unless you know the circumstances of why the text does not specify the nature of the contact you cannot possibly determine the reasons for confidentiality.

By the time an index case is symptomatic and tested, then their contacts identified and contacted, at least 5 days will have passed, so a test should be scheduled for day 7 by which time the incubation period is adequately passed for the vast majority. The incubation period varies, and some people show a positive test within a couple of days. That doesn't preclude anyone from being retested if they subsequently develop symptoms.

Failing to test close contacts, which WHO advised we should, is a massive hole in the test and trace plan, although there are other structural problems too.

I would be unwilling to isolate unless I had some credible reason to believe it was justified.

 

[Backache]

By the time an index case is symptomatic and tested, then their contacts identified and contacted, at least 5 days will have passed, so a test should be scheduled for day 7 by which time the incubation period is adequately passed for the vast majority. That doesn't preclude anyone from being retested if they subsequently develop symptoms.

Failing to test close contacts, which WHO advised we should, is a massive hole in the test and trace plan, although there are other structural problems too.

I would be unwilling to isolate unless I had some credible reason to believe it was justified.

The incubation period is known to vary,is sometimes quite long and the presymptomatic phase is probably crucial to spreading some results are coming back same day , it is entirely plausible that you can contact contacts sometimes within 48 hours.
In the meantime because the system is imperfect as a former public health doctor you believe that the system should be ignored ?

 

[Ethan]

The incubation period is known to vary,is sometimes quite long and the presymptomatic phase is probably crucial to spreading some results are coming back same day , it is entirely plausible that you can contact contacts sometimes within 48 hours.
In the meantime because the system is imperfect as a former public health doctor you believe that the system should be ignored ?

It is quite unlikely that you can contact people within 48 hours except in very unusual circumstances, and there is little evidence it happens often. The index case needs to get tested and results back, then contact Test and Trace and identify contacts, who need to be reached and interviewed. Even so, you can still schedule a test for day 7.

If you are concerned about presympimatic/asympomatic, then I presume you agree that close contacts should be tested, otherwise you will never know if they may have transmitted to others. NHS Test and Trace is ignoring WHO advice by failing to do so.

As a former public health doctor, I know that getting people on board requires their trust and belief in the system and an anonymous report by a random person who may or may not remember what you were doing as well as you would is not nearly sufficient.

 

[Ethan]

I had a fleeting dilemna when I had the text, but not isolating was never an option to be honest.
Did I have any symptoms, no.

Was it well over a week later, yes.

Did I go for a test, yes.

In the last couple of days, did I actually briefly nip into the supermarket to stock up, happy in the knowledge I'd been given the all-clear the day before (even though the 14 days weren't up), yes ?‍.

I work in an enclosed environment, I would never forgive myself if I did actually pass something on to any colleagues, especially those with vulnerable family members.

The bit in bold is the key part of this for me.

 

[Backache]

It is quite unlikely that you can contact people within 48 hours except in very unusual circumstances, and there is little evidence it happens often. The index case needs to get tested and results back, then contact Test and Trace and identify contacts, who need to be reached and interviewed. Even so, you can still schedule a test for day 7.

.

The contacts are those being contacted it is not contacts of contacts.You cannot just test them becuase you don't know when they will turn positive .
Yes there may be a case for testing them about day 10 -12 after their initial contact before you release them from quarantine but testing them on contact tracing may not help.

 

[SwingsitlikeHogan]

My work involves keeping networks for some major hospital trusts healthy and running - I don't work for the NHS - however am I a key worker? I only ask semi tongue-in-cheek.

 

[Ethan]

The contacts are those being contacted it is not contacts of contacts.You cannot just test them becuase you don't know when they will turn positive .
Yes there may be a case for testing them about day 10 -12 after their initial contact before you release them from quarantine but testing them on contact tracing may not help.

No, day 7 is fine. Index case gets symptoms, gets tested, IDs 1st round contacts. Those contacts should get tested around day 7 after exposure too. Then those who have positive tests should have their contacts ID'd too, 2nd round contacts, and so on until there are no positive tests.

You don't know IF they will test positive, but you have a pretty good idea WHEN they will test positive if they test positive at all.

OK, I think we have gone round the houses on this one quite enough. Bye.

 

[Ethan]

The official NHS advice said only go for a test if you have symptoms which I thought was a bit strange.
I phoned 119 and asked for a test, as a key worker I was booked in for a couple of hours later.

PS. Just had a missed call from NHS following up, they'll be phoning back.

It os worse than strange that they only test symptomatics, it is negligent.

Testing contacts should be routine, otherwise you will miss asymptomatic cases who can transmit. Seems that NHS Test and Trace is not bothered about that.

 

[pendodave]

The 'trebling in 5 days' wasn't about deaths - which, if you'd bothered to read the quoted post properly, you should have seen!
It was 'cases' which have gone from90 401 to 1209 in 5 days!
If 1200+ (or even 400) dying/being hospitalised after falling downstairs would, I believe, be cause for considerable concern in most countries!

Cases are not deaths. It's a false premise.
Over 5000 real, actual deaths a year are caused by falls. That's approx 5x more than covid for the last few months assuming an even distribution through the year. 10s of thousands more suffer life limiting and shortening injuries.
The number of deaths has increased by over 108% amongst the over 85s since 2006.
People die all the time in lots of unpleasant and preventable ways. They always have and they always will.
It'll probably happen to me, you and everyone else on this board.
Our 'cure' for one of an uncountable number of ways to die will kill and shorten far more lives than the disease. It'll probably have happened within 12 months and will proceed with gusto over the next 10 years or so. That's what closing down the nhs scanning services and reducing the size of an economy by 20% does.

 

[Ethan]

Cases are not deaths. It's a false premise.
Over 5000 real, actual deaths a year are caused by falls. That's approx 5x more than covid for the last few months assuming an even distribution through the year. 10s of thousands more suffer life limiting and shortening injuries.
The number of deaths has increased by over 108% amongst the over 85s since 2006.
People die all the time in lots of unpleasant and preventable ways. They always have and they always will.
It'll probably happen to me, you and everyone else on this board.
Our 'cure' for one of an uncountable number of ways to die will kill and shorten far more lives than the disease. It'll probably have happened within 12 months and will proceed with gusto over the next 10 years or so. That's what closing down the nhs scanning services and reducing the size of an economy by 20% does.

People who fall tend not to fall on other people who in turn fall on more. You never hear a report saying that one fall in Preston is thought to have led to up to 30 other falls. Falls are isolated events, a transmissible infection is not.

 

[Ethan]

Actually, that happened in a pizza ? delivery shop near here.

Can't remember the name ?

Were the victims well refreshed?

 

[Foxholer]

Cases are not deaths.....

Well, the whole (and singular) point of my post was to highlight that cases had trebled (in 5 days)!
And FWIW, your subsequent 'argument' is plainly ridiculous! Your logic, if extended, would advocate abandoning all sorts of medical/healing support/care for ANY potentially lethal ailment/malady - simply because folk die from 'all sorts of other causes'!