Covid-19: 90% of cases will hit NHS over nine week period, chief medical officer warns
BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m918 (Published 05 March 2020) Cite this as: BMJ 2020;368:m918Read our latest coverage of the Coronavirus outbreak
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Dear Editor
Firstly I write in support of Dr Salmon. I too consult the Robert Koch Institut every day - even though, at the moment I am not planning a journey.
The CDC in England ought to follow the RKI.
SECONDLY and equally important: the Chief Medical Officer of England should advise the Minister to do what is best, for bringing the epidemic under control At the Earliest. Never mind trade.
And if the Minister rejects the advice even partially, the CMO ought to go public.
In the times of Sir George Godber, we (the public health doctors) always felt that Sir George’s advice was more than a match for the politicians.
Competing interests: No competing interests
Dear Editor
While most discussions about pandemic planning in recent years have focused on pharmaceutical preparedness (which has suited an industry) what we now find ourselves most short of is medical professionals and beds [1] . Despite this being the heroic age of vaccines (even with many laboratories tinkering with Coronavirus variants over the past two decades), we do not know if or when vaccines will be available, we will not be placed even with the best testing to know what their long term health effects might be, and the virus may easily have mutated again anyway. In 2009 the British public at least were suspicious of a vaccine developed over 4 months because of swine flu and uptake was only around 10% [2]. This time the disease may seem significantly more menacing but it is not really clear that rushed to the market antidotes will be any more enticing. Of course, it may be different if people are forced to take the vaccines but that will have huge penalties in public trust.
As it is preparedness has had nothing to with products that may or may not be available in x months time - it has been to do with limiting the spread of the new disease, finding out how to treat it with existing products (even if not under corporate patent) and having sufficient hospital infrastructure.
[1] Elisabeth Mahase, 'Covid-19: 90% of cases will hit NHS over nine week period, chief medical officer warns',
BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m918 (Published 05 March 2020)
[2] John Stone, 'Re: A tale of two vaccines - how the British people averted disaster?', 13 October 2018, https://www.bmj.com/content/363/bmj.k4152/rr-17
Competing interests: AgeofAutism.com, an on-line daily journal, concerns itself with the potential environmental sources for the proliferation of autism, neurological impairment, immune dysfunction and chronic disease. I receive no payment as UK Editor
Dear Madam,
Should I go on the website of Sante Publique France, I can download a pdf document, summarising the situation in France, as of yesterday afternoon and documenting the affected regions as well as a simple age and sex breakdown of the cases. Similarly, for Germany, the Robert Koch Institute summarises the cases in Germany, as of 8.00am, local time, this morning and includes advice about the cluster in North-Rhine Westphalia. Previous versions of the update have also included summary age ranges, with mean and median, as well as a breakdowns by sex and information about the place of likely exposure.
By contrast the Public Health England website (to which the Public Health Wales website directs me) contains only a bald total of the number of confirmed cases and deaths with no additional epidemiological information, other than the number of virological tests performed. This potentially handicaps both clinicians, who may wish to use such information to make a preliminary assessment of the likelihood of CoV 2019 infection, as well as citizens who are deprived of information that may allow them to make reasonable modifications of their behaviour. It also sits uneasily alongside official claims for transparency and raises the question whether, as a branch of the Department of Health and civil service, Public Health England has sufficient institutional and organisational independence to be a credible public health agency.
Yours faithfully,
Roland Salmon
Dr Roland Salmon
Consultant Epidemiologist (Retired)
CARDIFF
Competing interests: No competing interests
Re: Covid-19: 90% of cases will hit NHS over nine week period, chief medical officer warns
Dear Editor
Maybe I have not learnt to search the internet properly. But can someone kindly tell me, please:
1. The temperature at which the Virus will be inactivated (“killed “ is perhaps the wrong term for a virus).
2. Will the virus be inactivated by acetic acid (vinegar, for example), petrol, alcohol (the strength of beer? Wines? Fortified wines? Brandy? Whisky?).
3. Given that desiccation will not inactivate the virus, how do we render clothes, toys, non-infectious?
4. Imagine that you are going to the GP surgery or the hospital (without access to a private car of your own).
You climb on the bus, holding a rail, sit down, perhaps holding another rail. You get down holding a rail. Your ticket or bus pass has been touched by an electronic reader which has been touched by numerous other passengers. You go to a pedestrian crossing, press the red button, cross halfway. Then press another button. At the GP surgery you check in using the electronic screen which has been touched by many others. The surgery cannot have the means to wipe the buttons clean after every patient.
Any solutions, please? I can only think of one - wear a disposable glove for touching buttons and discard it when you reach the surgery or hospital. In the meantime, resist the itch or the tickle.
Now to the Chief Medical Officer and his forecast of how the outbreak will turn in to an epidemic.
Would it not make sense to cut down transmission rate NOW? Why not ban now, events where people congregate? Why not close down most of the government offices NOW? Who knows you might find that people working from home are as productive as those spending three hours a day travelling?
Cut down transmission rate now and it will spread the burden on the NHS over a longer period.
Competing interests: No competing interests