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General => The Stay Safe Board => Topic started by: bykerlads on Friday 17 April 20 19:18 BST (UK)
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With ref the Virus, I am a bit concerned that the official online and 111 screening/advice process in the Uk is too severe, perhaps with the original, justifiable intention of trying to avoid floods of folk going to hospital for treatment.
If, as we are told, there are currently many empty ICU/Nightingale beds, at the same time as too many deaths, surely it implies that ill people are being put off going to hospital until they are too ill to be saved.
Certainly, in my household we will be seeking hospitalisation earlier rather than later, should we show symptoms of Corvid 19.
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I can only speak in relation to my daughter who rang 111 when her temperature reached the mid 39 degrees to which the response was - no admittance to hospital until your temperature is in the mid 40's.
It didn't actually get to 40 and she was fine after a few days.
Pheno
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As far as I can gather, most cases start the same way, relatively mildly. After a few days/a week or so, you realise that things are not getting better, or perhaps a sudden deterioration. Then admission to hospital, assess and treat for a few days. Increasing amounts of oxygen failing to increase oxygen saturation levels - bipap/cpap. Still no improvement - transfer to ITU for ventilation.
Then a week or maybe longer on a ventilator, then slow recovery, or unfortunately death.
I wouldn't want to go to hospital, but I would be off like a shot, especially if I was having difficulty in breathing. The official reason why there are still empty beds is that social distancing is working, rather than that people are being admitted too late.
Regards Margaret
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I think that if one is ill especially with fever and breathing difficulties, you are potentially incapable of ensuring your own welfare. You need someone there at home with you who is capable of assessing your condition and insisting that you are given expert treatment.
My personal, limited experience of being ill with fever and infection is that it takes away half of your brains/ intellegence/awareness/ability to analyse.
My advice to anyone would be, if in doubt, to insist on hospital, Stand your ground. Don't be fobbed off.
Our nhs staff are experts. Use them.
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I don't think you can "insist on hospital" especially at the moment. Yes, there are empty beds prepared for virus patients but they also need adequate staff to deliver patient care.
My daughter's asthmatic neighbour who lives alone had coronavirus and developed breathing problems. He rang the 111 number and just was told to stay at home and only ring if much, much worse.
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Really chilling and frightening to hear that potentially fatal delay is being recommended or rather ruled upon by 111operatives on the basis of a verbal account from a very ill and weakened patient.
Can anyone tell us how we should go about getting hospital (ie life-saving) treatment for corvid. Surely we can ring 999 or go to a hospital?
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If you are having a heart attack or stroke, the advice isn't to ring 111.
You ring 999 and go immediately to hospital.
An asthmatic patient could be having a severe attack, completely unrelated to coronavirus. If they delay treatment by talking to someone at the end of a phone, they could die with status athmaticus.
Paramedics and hospital staff should by now assume that every patient has coronavirus, whether or not that is their initial presentation, and take appropriate precautions.
On that basis, why ring 111 for advice if suffering severe breathing difficulties due to suspected coronavirus?
Ring 999 or go to A and E.
It is up to properly trained paramedics or hospital staff to assess you, not someone at the end of a phone line.
May not be official advice, but is something I would consider if I or a family member was having extreme difficulties with breathing.
Regards Margaret
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It is quite hard to get through to 111 at the moment.
My 91 year old dad has had the virus and they couldn’t get through on 111 when his breathing started to get bad. The following day, he phoned his local surgery and his GP called back. His advice was to stay at home as his temperature was coming down by then (day 14) but ring again if his breathing got worse. He certainly sounded very raspy and catching his breath on the phone. It was very frightening.
Thankfully, my dad has recovered... tough old stick!
My brother was with him the whole time and giving him extra vit C and any vit D foods and when the weather improved he sat outside as much as possible.
If your breathing gets worse after ringing 111 or your GP, then ring 999. Do not go to A&E, you will be spreading the virus to possibly vulnerable people!
Check your local hospital’s website for instructions in your area. My husband has to go for treatment at Basingstoke hospital and they have set up a separate entrance for all COVID patients. 4 weeks ago my husband’s treatment was inside the main building, now oncology have taken over the private suite located in another building to distance cancer patients who need regular treatment.
If you are isolating at home and following the rules then the chances of getting the virus is greatly diminished.
Stay safe, don’t watch too much news and avoid the ridiculously alarming fake news in certain newspapers.
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I wonder what 111 says if like me you do not have a thermometer.
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They specifically say that you do not need to take your temperature with a thermometer: https://www.nhs.uk/conditions/coronavirus-covid-19/symptoms-and-what-to-do/
a high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
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I wonder what 111 says if like me you do not have a thermometer.
Same as they told my Dad!
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At the start of the virus crisis we too had no thermometer. Never have had one.
None to be had locally in shops , so ordered one online. After 3 weeks one arrived, ironically it was made in China and apparently sent from there too.
We put it into 7 days quarantine as a precaution.
I still feel it is worth questioning the Covid pre-hospital admission screening online and via 111. Is its severity actually causing more deaths due to delay in getting treatment?
I wonder what the systems are in other countries?
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Can anyone tell us how we should go about getting hospital (ie life-saving) treatment for corvid. Surely we can ring 999 or go to a hospital?
I think even if you do that, you could still be refused admittance if you don't reach their criteria. There was a man on the news the other day who was told by his GP to go to the hospital, but when he got there they told him to go home. It was only after a couple more days and the direct action of the doctor that he was admitted and went straight to ICU. Luckily he recovered.
It does sound very much as if there is no treatment apart from the oxygen and that is why there is no point going to hospital until you need to be given that.
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I had to take my elderly Dad to a London hospital this week due to his severe and worsening breathlessness. They were amazing. No delay - they immediately identified his low oxygen sats level in the (empty) waiting area, and rushed him through for urgent assessment in A&E. They were very clear that seeking urgent help was the right thing to do and people must not be reluctant to seek medical attention for dangerous conditions.
I was not allowed to go in with him, but the staff were great and kept me updated on his condition by phone.
His chest x-ray showed lung signs consistent with Covid but which could have been caused by another condition. He was not swabbed for Covid because they only swab people who are admitted. Once his oxygen sats had stabilised they explained to me that they were not admitting him as if he didn’t already have the virus he would catch it there. Instead he is being actively monitored by hospital staff at home, with home visits every other day and phone calls in between.
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That sounds as if he had excellent treatment, I hope that he is well on the way to recovery now. The not testing does seem a bit silly to me - how will he ever know if he had it or not unless later everyone is tested for antibodies? Why not just test everyone who presents with symptoms, then at least we might have more accurate data.
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Low oxygen saturation level in the blood (Hypoxemia) is one indication of a breathing or circulation condition. All the best avm228 and All.
I found NHS 111 absolutely excellent! I was assessed and went into A & E straight away when my B.P., went up high (on my home monitor), 210/120 at hospital. That can be Stroke territory, but reduced to a max safe level and was home late the same day after several tests.
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deleted accidentally reposted
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There seem to be some blood oxygen level monitors available for use at home, just clip them onto your finger.
Are these any use/reliable?
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Yes, Dad now has a home sats monitor which helps to keep an eye on things.
I agree that not testing is daft. I had suspected Covid myself a month ago (not diagnosed, but classic symptoms) followed by viral pleurisy which was diagnosed. As a sole carer for three vulnerable elderly people - father, mother and stepfather - it would have been really helpful to know for sure whether I had it.
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There seem to be some blood oxygen level monitors available for use at home, just clip them onto your finger.
Are these any use/reliable?
My monitor only does B.P. It overreads very slightly when my G.P. compared it with his.
Added
"Pneumonia can lower the oxygen in your blood because the air spaces in your lungs fill with mucus."
Do long term smokers get different oxygen blood saturation levels? Because some will have COPD.
Mark
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Avm, can I ask if the home blood oxygen monitor which you mention is the same as the ones which can be bought on Amazon? Or is it a special kind provided by the hospital or doctor?
Am just thinking that that an oxygem measurement taken at home would be a useful tool in determining if someone needs hospitalisation: a high temperature and low blood oxygen couldn't be argued with by 111.
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Had to take my mum to hospital last week for something completely unrelated - a bleed which needed professional attention.
We lost our A&E a few years ago, and it was eventually replaced by an "urgent care centre", and this was our first experience of it. We needn't have worried. All seemed to be well organised.
It had an entrance entirely separate from anything Covid-19 related. Triage took place at the entrance by a senior nurse in full gear. I was told to wait in the car (they have suspended car park charges).
The wait time was short, and all was dealt with speedily. A very positive experience.
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Can anyone tell us how we should go about getting hospital (ie life-saving) treatment for corvid. Surely we can ring 999 or go to a hospital?
I think even if you do that, you could still be refused admittance if you don't reach their criteria. There was a man on the news the other day who was told by his GP to go to the hospital, but when he got there they told him to go home. It was only after a couple more days and the direct action of the doctor that he was admitted and went straight to ICU. Luckily he recovered.
It does sound very much as if there is no treatment apart from the oxygen and that is why there is no point going to hospital until you need to be given that.
My daughters partner has his mother in a Care Home in Gloucestershire . They phoned yesterday to say they have four confirmed cases among the residents. None of whom are going to hospital. They have been on lockdown since the very beginning so it would seem a staff member has introduced the infection into the home. They now have to wait to see if one of the carers goes down with it.
It really is time someone got their act together to test all NHS and care workers. Locked up in a care home the elderly are sitting ducks, !
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Really reassuring to hear good NHS stories.
I think everyone should have a Plan of what to do, where to go, who to contact in case of need.
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Bykerlads, I think my father’s pulse oximeter was supplied by his medical team, but have no reason to think you can’t get something just as useful online.
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Really reassuring to hear good NHS stories.
I think everyone should have a Plan of what to do, where to go, who to contact in case of need.
I'm rather sceptical and I don't think whatever your plan that it will necessarily be carried out. We will have to rely on medical staff to make the decision as to whether you are ill enough to be admitted to hospital. That may also depend where you live and how full the hospitals are.
The best plan is to try and avoid getting it in the first place by not going out unless really necessary.
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Bykerlad,
I am in South Australia. The testing here is tops.
Ring the doc for a referral, go to special clinic for testing, be assessed and isolated if need be or sent to hospital. Testing results can come back in 45 minutes for bad symptoms (costs more but very effective). We have just had 2 days of increased numbers being tested.
I am very lucky, on a farm and self isolating. No one in our town is positive and we are in lockdown except for essential workers.
I am devastated for you all.
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Really reassuring to hear good NHS stories.
I think everyone should have a Plan of what to do, where to go, who to contact in case of need.
I'm rather sceptical and I don't think whatever your plan that it will necessarily be carried out. We will have to rely on medical staff to make the decision as to whether you are ill enough to be admitted to hospital. That may also depend where you live and how full the hospitals are.
The best plan is to try and avoid getting it in the first place by not going out unless really necessary.
More sound advice there.
The way I see it if your symptoms are bad enough then 111 will send paramedics, they will decide if you need hospital, based on their now considerable experience.
If you can breathe well enough to talk you most likely don’t need to go to hospital.
Worrying about it too much can itself provoke your immune system into overdrive.
If you are fit and healthy then on the current figures you have a one in four million chance of dying.
Mike
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I'm rather sceptical and I don't think whatever your plan that it will necessarily be carried out. We will have to rely on medical staff to make the decision as to whether you are ill enough to be admitted to hospital. That may also depend where you live and how full the hospitals are.
The best plan is to try and avoid getting it in the first place by not going out unless really necessary.
I agree totally with groom.
I've not read all of the thread - are you in one of the vulnerable groups?
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I absolutely agree that the best plan is to avoid getting the virus in the first place. And we are all working hard on this.
But I still think that some thought should be given to how to ensure that one gets access to the best treatment as soon as possible.
If ill people got immediate access to medical treatment, there would perhaps not be so many fatalities.
I still have the uneasy feeling that the screening/advice/111 criteria are standing in the way of folk getting expert help.
One needs to be proactive in an extreme situation, not a compliant victim. Insist on getting hospital treatment.
Despite all the heroic efforts of our nhs workers in the UK, we seem to not be doing too well compared to other cou tries. ( though of course the "statistics game" is always open to closer scrutiny)
I would like to see far more people sent for specialist treatment in good time, rather being advised to stay at home, inexpertly cared for, until their condition worsens beyond salvation.
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One needs to be proactive in an extreme situation, not a compliant victim. Insist on getting hospital treatment.
Yes, in an ideal world, this would happen but it seems to me that you've not been following any of the bulletins, information, etc.
Try turning up at the Dept of Health and demanding treatment in the real world.
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In the real world sensible reasonable people get the best treatment possible including going the extra mile.
The less tolerant get exactly what the book says, no more no less.
In fact there is no “treatment”, Just oxygen if you really need it, to stay alive, after that it’s down to you and your immune system.
Mike
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Yes, Exactly. I do agree.
Though getting oxygen to stay alive seems like treatment to me.
Getting access to oxygen to stay alive should be available to us all.
Am currently trying to compare UK systems of dealing with the virus with those of other developed countries. That should enable us to check if our system is serving us well or, despite everyones efforts and good intentions, preventing us from getting timely medical, life-saving interventions.
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Comparisons have been made with Germany. that put us in a bad light.
I'm in the vulnerable category so I'm not taking any risks. I take walks around my garden rather than outside, and everything that comes into the house from the big outside world is thoroughly cleaned. Newcastle has a very good health care record but is halfway up/down the tier stats.
If I had some of the more serious symptoms, I'd phone 999 or my GP. I wouldn't phone 111.
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I am beating my head against a wall at present, my husband has been unwell since Good Friday, if I am to believe him, by Sunday he was much worse, slept all day except meal times, I thought he might have had a UTI as he was quite nasty to me on Sunday, Tuesday he was feeling much better and managed to go for a blood test on Wednesday, Thursday again he was much worse, he can somehow sleep most of the day and still get at least 7 hours at night, he believes he has had covid 19, he will not allow me to ring 111 or the Dr, I really cannot understand how he can diagnose himself, he is a little better today but this has gone on for 10 days now and I am now locked in just in case
Louisa Maud
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Ring the Doctor! Just in case. There are other things it may be, and could be equally important.
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I have made up my mind I will do that, my OH is very stubborn
Louisa Maud
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would like to see far more people sent for specialist treatment in good time, rather being advised to stay at home, inexpertly cared for, until their condition worsens beyond salvation.
So would everyone. However, the problem is they can't do that, as there just aren't enough hospital beds or NHS staff to cover everyone who gets CV. So the decision has been made that only those who fit the criteria are admitted to hospital, which, given the situation is right. It would be dreadful if beds were taken up by those who could be treated at home, meaning that those who were seriously ill couldn't be admitted.
For some reason the UK isn't releasing figures to show how many people actually get CV and recover. I suspect this is because we aren't testing enough people to know. We need to reach the stage when everyone who thinks they have the virus is tested.
Death rates have fallen today, but that could be because it is the weekend and not all have been recorded. We should know by Tuesday if they are actually going down.
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But deaths are still just those who die in hospital. No care home or home deaths included in those figures. These come out once a week but a week in arrears and cause of death has been recorded in various ways.
I've lost faith in the figures because we can't compare them with anything. I carried out a lot of statistical analysis (even on health data) in my earlier career and I don't have any confidence in them whatsoever.
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They say you can prove anything with statistics.
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There are rules and they aren't following them.
Just to give an example. Unless you know how many people have had Covid (symptomatic or non- s) and how many have died from it and the population base, what do they tell us? Not a lot.
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That's exactly why I don't bother reading them.
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I agree with Gadget - no-one has any idea whatsoever in the UK how many people have the virus, or indeed how many people have died from it. If you become unwell, you're told to stay at home, not phone 111, not contact the GP - so basically you're on your own, abandoned, until such time as you either get better or deteriorate. No-one knows if you have the virus or if it's something else, so you can't be counted in the statistics.
My daughter was supposed to have surgery at the end of March. She was discharged from hospital, and surgery cancelled because of CV, so now she's isolating until such time as surgery can be done. On 25th March she developed a cough, and I got one a few days later. Three weeks later we still have coughs; we've looked up symptoms and they don't really match CV symptoms - except that it also says that possible other symptoms could be.... it seems everyone has something different.
The important thing here (assuming we both recover, of course) is whether or not we have had CV and without testing we won't know. So, we don't know whether we need to isolate to protect other people from us, or to isolate to protect us from other people. Clearly this situation needs to be addressed as there must be tens of thousands of people in similar situations. And I don't see how it would be safe to repeal the lockdown unless testing and tracing were in place.
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On the Downing Street Briefing today (Sunday) the chart now showed two lines for the UK:-
i) in hospital and
ii) in hospital AND other settings.
Our Coronavirus UK deaths in hospital and other settings are still about the same as France and Italy.
The chart lines for each country, originally started when 50 deaths were reached in that country.
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Covid-19 is a highly contagious communicable immunogenic disease and our own immune systems need to fight the virus to get better.
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For those not getting better, once hospitalised oxygen and a drip seems popular.
Usually recommended that at home for any virus, that I should drink plenty.
The husband of my Sister's friend was on oxygen, but had sudden deterioration and was told that on commencement of invasive ventilation his life expectancy would only be 50/50. However, thanks to Doctors and Nurses keeping him stable and his own immune system he pulled through and survived Coronavirus.
Mark
ADDED
UK NICE Guidelines
"Deciding about hospital admission"
https://www.nice.org.uk/guidance/ng165/chapter/4-Managing-suspected-or-confirmed-pneumonia
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Following on from Mark's link, the full NICE Covid-19 guidance makes interesting reading.
https://www.nice.org.uk/guidance/ng165/chapter/1-Communicating-with-patients-and-minimising-infection-risk
Parts 2, 3 and 4 available as links on left hand side of page
Regards Margaret
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Hospitals can be dangerous places.
I have 25 years working in them hence I have a fair amount of first hand experience.
Staff are and always have been very badly treated by successive Governments as have the Trusts by rampant cuts.
All NHS and supply chain Staff do an exceptional job in keeping the system running.
My roles were medical support related and whenever I had new staff start I always advised them at the interview that the first two years would be rough for them, they would be exposed to bacteria and virus’s that would affect their health but they would become resistant and more resilient over time. It is like being a kid again and picking up all the playground illnesses.
Hence the advice not to go to Hospital is a risk assessed response, simply going into hospital places the patient at an even greater risk.
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Hospitals can be dangerous places.
I have 25 years working in them hence I have a fair amount of first hand experience.
Staff are and always have been very badly treated by successive Governments as have the Trusts by rampant cuts.
All NHS and supply chain Staff do an exceptional job in keeping the system running.
My roles were medical support related and whenever I had new staff start I always advised them at the interview that the first two years would be rough for them, they would be exposed to bacteria and virus’s that would affect their health but they would become resistant and more resilient over time. It is like being a kid again and picking up all the playground illnesses.
Hence the advice not to go to Hospital is a risk assessed response, simply going into hospital places the patient at an even greater risk.
I had Chronic Bronchitis every year as a child, an absolutely exhausting and frightening illness, my Mum refused our family Doctor's advice for me to go into hospital and sat at my bedside until I fell asleep each night. I've always had Vaporub in the cabinet since.
Our Family Doctor use to come back with a liquid Medicine and that often helped my Bronchitis.
Yes, the NHS and care from Staff is wonderful! Mark
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It certainly does, I've gone from one link to another to another!
Added note: Sorry, my comment doesn't make much sense, I thought I was adding it much earlier in the thread, I hadn't seen the further comments. :-[
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Who was it said:
"There are lies, damned lies, and statistics"
I've heard it attributed to a Dumas (not idea which one) but not at all certain.
But the older and more cynical I get, the more I believe it! Anyone's statistics, on anything.
TY
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I was heartened to read today that confirmed hospital cases here in Sussex have fallen for the last three days in a row. The numbers are coming from the hospitals to local media, so I’m happy that the information is correct.
No figures for care or nursing homes sadly :(
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Who was it said:
"There are lies, damned lies, and statistics"
I've heard it attributed to a Dumas (not idea which one) but not at all certain.
But the older and more cynical I get, the more I believe it! Anyone's statistics, on anything.
TY
Popularised apparently by Mark Twain but its originator is not clear.....
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Yes, he's another one that I've heard it attributed to.