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39 minutes ago, john.r.davies said:

Richard,

In the last forty years, the medical use of sterile items has moved away from reusable kit to the disposable.   Sterilization is labour intensive and energy intensive, and so costly, and single-use kit is cheaper.       The only re-usable kit is use today is too expensive to be disposable. such as endoscopy 'scopes and some surgical tools.    Even the last are disposable if possible.    I have several sets of beatiful ophthalmic scissors and forceps, that are very useful for delicate work such as removing splinters!   I kept them from the bin and sterilized them myself.     Surgical drapes and gowns are disposable and thrown away.   As a result, theatre autoclaves went the way of the dinosaur long ago, and Central Sterile Supply Depts, sometime working for many hospitals, provide packs for each operation.   

Then, PPE kit must be impermeable so that the patient's secretions do not penetrate.   I've often seen a surgeon remove  their gown to see blood on their scrubs.     This doesn't matter, the surgeon removes those and washes.    The fear in surgery is that  the operator infect the patient, not the other way around.     The impermeable material of PPE kit will not stand the heat or chemicals that can sterilize them.    No doubt a materials scientist could change that, but that's how they are.    You can't resterilize them, and you don't have anywhere they can be resterilized.

Finally, as any giant corporation (and the NHS used to be said to be the biggest in Europe, short of the Soviet Army, so it is the biggest now) will do, it has its own procurement department, "NHS Supply".    Apart from anything else, that can obtain the benefits of cost in large orders, and hospital managers order from them.   Why do anything else, if NHS supply can provide the goods?    This leaves little to be bought elsewhere in the UK, and the current situation leaves little elsewhere in the World.   So it is unfair to blame local NHS managers.

NHS Supply is a subsiduary of the NHS, and that cannot invest in strategic stores of PPE or anything else - it cannot afford to do so!     Who has that responsibilty, and funding?  This Government, which ran down such stores in the ten years it has had that responsibility, and then failed to rebuild them in the face of approaching menace, despite urgent advice from its own  experts.

John

I hate politics but if insist do you forget the Americans bailed us out with money when the Labour Government took over after the war. Moving on Blair took us into a war that we did not want. Gordon Brown spent all our gold reserves and on leaving Government left a note there’s no money left in the bank 

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Today at London Heathrow 90 planes are going to arrive carrying PPE , this is history being made for LHR. The planes are Passenger planes with their holds full and also where the passengers would be.  ie seats floors etc will be stacked with PPE. 

You can watch this live here:

 

Edited by SuzanneH
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If this is indeed the case I guess we have heard nothing about it from HMG since they want first to be sure the equipment is to specification,  having reportedly been caught before.

Tim

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4 hours ago, ntc said:

I hate politics but if insist do you forget the Americans bailed us out with money when the Labour Government took over after the war. Moving on Blair took us into a war that we did not want. Gordon Brown spent all our gold reserves and on leaving Government left a note there’s no money left in the bank 

That's the problem, the Tories have their faults (myriad) but the Labour party are so much worse and have the track record to prove it.  Oh for a sensible voting system that didn't create such a polarised and idealogical government - other countries seem to manage it.  Holland and Germany spring to mind but there are plenty more

Rgds Ian

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I don't know who we can believe or not these days but if the attached email I got from Jaguar is valid,  https://mail.google.com/mail/ca/u/0/?shva=1#label/Car/WhctKJVqvwHzpptQphgQGBBJkBBxTjGnVKwlLPXjHdvZPxMGVwNZJqKjRvNkkTZBFKWFTKQ

isn't it typical this does not appear to be being shouted about loud and clear by the BBC and all the other anti government media who just keep banging on about all the negatives  - yes OK they have mentioned other people (F1 etc ) doing stuff but never that I have seen in a way to offset all the negative hype. Oh and by the way John, Jaguar seem to have cottoned onto the idea that re-useable PPE is a possibility and certainly better than nothing - is it surprising that the collective might of NHS procurement can't do the same - one dimensional yes men could be an explanation - Government's fault, I think not.

On a similar theme, fancy the BBC reporting in headlines on the news the other day that the heads of Burberry and Barbour had contacted the BBC to seek assistance in contacting relevant authorities to help - I couldn't believe that story was true and it seems that it couldn't have been totally true as subsequent reporting was very different - not only, to my mind, does that portray a very poor image of the BBC but it doesn't say much for the two companies involved either.

I wish the politicians being interrogated by the media over all this would really fight back and bury all the negative hype! 

Cheers ( is it?) Rich

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Suzanne,

Ninety aircraft?  At Heathrow?    The story I heard was that the RAF had one plane, waiting to bring 84 tons of PPE from Turkey, today, including 440,000 sets.

90 planes would mean 36 million gowns.    Our problems are over!   Hail the Dawn of a New Age for the NHS!    But I fear that reality will be different.   I'm listening to the BBC news, now.  No mention of that RAF flight, yet.   Fingers crossed.

John

PS BBC just  (1703) announced the consignment is at Ankara airport for loading by the RAF

Edited by john.r.davies
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31 minutes ago, john.r.davies said:

Suzanne,

Ninety aircraft?  At Heathrow?    The story I heard was that the RAF had one plane, waiting to bring 84 tons of PPE from Turkey, today, including 440,000 sets.

90 planes would mean 36 million gowns.    Our problems are over!   Hail the Dawn of a New Age for the NHS!    But I fear that reality will be different.   I'm listening to the BBC news, now.  No mention of that RAF flight, yet.   Fingers crossed.

John

PS BBC just  (1703) announced the consignment is at Ankara airport for loading by the RAF

Just watch the video ( now recorded/ no longer live) this is a special event with special permission to be there and also permission from L B Hillingdon. Listen to what the chap on commentary is saying. 
if it’s not true then my apologies but I believe it. This chap often broadcasts from Airports around the world for plane freaks but for the last few weeks he has been broadcasting from his home ( home cam) in his garden with the occasional plane going up or over from LHR.

Edited by SuzanneH
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Did I mention the Covid Symnptom Tracker before?  See covid.joinzoe.com

and download it to your phone to report your own experience, to help the epidemiologists at Guy's & St.Thomas'.

They will be holding a webinar on the 23rd when Doctors and clinical researchers Claire Steves and Tim Spector will share an update on the insights they're learning from the app..

See https://zoom.us/webinar/register/6915873908274/WN_X0KrlhfVTE-q7v539VKz8w

 to register for the event.

It will download a copy of Zoom (that my Norton Firewall says is "Safe")

Edited by john.r.davies
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15 minutes ago, john.r.davies said:

Did I mention the Covid Symnptom Tracker before?  See covid.joinzoe.com

and download it to your phone to report your own experience, to help the epidemiologists at Guy's & St.Thomas'.

They will be holding a webinar on the 23rd when Doctors and clinical researchers Claire Steves and Tim Spector will share an update on the insights they're learning from the app..

See https://zoom.us/webinar/register/6915873908274/WN_X0KrlhfVTE-q7v539VKz8w

 to register for the event.

It will download a copy of Zoom (that my Norton Firewall says is "Safe")

 

Yes, reporting daily John

We use Zoom between our family homes . . .it works well, but, for security I would rather use Microsoft Teams, the problem is, you need a Microsoft account and a copy of Office downloaded . . . . .I use WPS Office;

https://download.cnet.com/developer/kingsoft-office-software/i-10168761

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I have been reporting on this one when I remember. I received an e- mail from them today  advising they want more families to take part and especially 70+

F39EE35B-77A6-461A-9AF7-8E9D4309E461.jpeg

Edited by SuzanneH
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3 hours ago, SuzanneH said:

I have been reporting on this one when I remember. I received an e- mail from them today  advising they want more families to take part and especially 70+

F39EE35B-77A6-461A-9AF7-8E9D4309E461.jpeg

 

Ditto Suzanne .. . .same one

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Peter, et al. Something dawned on me from reading the Tim Spector review and the P.N.Taylor & J.S.Davies paper he cites. Taylor & Davies stated (as we already knew) that Vit D toxicity is due to increased calcium absorption from the gut, leading to hypercalcaemia. This happens, they say, due to overdosing on Vit D, typically mis-prescription (e.g. "more is better") or poor control of the dose in pills in what is an un-regulated industry, because "it's only a vitamin". In the USA, and perhaps other places, milk is fortified with vit D and one instance of much increased dosing led to 50-odd cases of hypercalcaemia including 2 deaths.

At the same time I was listening to "A History of the World in 100 Objects" on R4, in which they commented that 8000 years ago we humans would not have drunk milk as adults. Which made me think (well, there's a first time for everything!) when we were walking around the plains of Africa, where did we get our calcium from? Our (non-dairy) diet of course, with absorption via the gut aided by our high vitamin D levels. Moving out of Africa, most peoples of the world still don't drink milk. Albeit some countries such as India use butter and yoghurt in cooking, which is milk processed to remove or convert the lactose.

Which brings us to Europe where we do drink milk and the vast majority of people are lactose tolerant. However, gone are the days when we were implored to "drinka pinta milka day" and we had milky coffee, because the instant or percolated coffee was so awful you have to. I probably drink 1/3rd pint each day. My Nearest & Dearest did the maths some years ago and she found it was really quite difficult to get the recommended amount of calcium by diet alone. One wonders what 25OHD3 level the recommended calcium intake was calculated for?

Lactose tolerance was a particularly useful characteristic to evolve for peoples in northern climates, because even if we were struggling to get enough vitamin D, at least we would still be getting enough calcium. Trouble is, now we can supplement to get optimal vitamin D, it makes it easier to overdose on the calcium. One wonders how many of the hypercalcaemia cases were associated with high milk consumption, or calcium supplementation? My wife had already stopped taking the tablets she calculated she needed!

Cheers, Richard

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1 hour ago, Spit_2.5PI said:

Peter, et al. Something dawned on me from reading the Tim Spector review and the P.N.Taylor & J.S.Davies paper he cites. Taylor & Davies stated (as we already knew) that Vit D toxicity is due to increased calcium absorption from the gut, leading to hypercalcaemia. This happens, they say, due to overdosing on Vit D, typically mis-prescription (e.g. "more is better") or poor control of the dose in pills in what is an un-regulated industry, because "it's only a vitamin". In the USA, and perhaps other places, milk is fortified with vit D and one instance of much increased dosing led to 50-odd cases of hypercalcaemia including 2 deaths.

At the same time I was listening to "A History of the World in 100 Objects" on R4, in which they commented that 8000 years ago we humans would not have drunk milk as adults. Which made me think (well, there's a first time for everything!) when we were walking around the plains of Africa, where did we get our calcium from? Our (non-dairy) diet of course, with absorption via the gut aided by our high vitamin D levels. Moving out of Africa, most peoples of the world still don't drink milk. Albeit some countries such as India use butter and yoghurt in cooking, which is milk processed to remove or convert the lactose.

Which brings us to Europe where we do drink milk and the vast majority of people are lactose tolerant. However, gone are the days when we were implored to "drinka pinta milka day" and we had milky coffee, because the instant or percolated coffee was so awful you have to. I probably drink 1/3rd pint each day. My Nearest & Dearest did the maths some years ago and she found it was really quite difficult to get the recommended amount of calcium by diet alone. One wonders what 25OHD3 level the recommended calcium intake was calculated for?

Lactose tolerance was a particularly useful characteristic to evolve for peoples in northern climates, because even if we were struggling to get enough vitamin D, at least we would still be getting enough calcium. Trouble is, now we can supplement to get optimal vitamin D, it makes it easier to overdose on the calcium. One wonders how many of the hypercalcaemia cases were associated with high milk consumption, or calcium supplementation? My wife had already stopped taking the tablets she calculated she needed!

Cheers, Richard

Hi Richard,

Spector is talkingt hough his hat. Actual evidence for hypercalcemia due to D3 is extremmely rare and is apochryphal. In the 1930s wehn cod lver oil was used to cure TB there were instances of hypercalcaimai but they had no way to measure the doses back then. Nowadys there are rare conditions eg sarcoidosis wher high D3 risks hypercalcamia and these can be warned by GP. Kidney stones would also be warning sign of something amiss with Ca metabolism that needs sorting by GP

D3 does promote Ca and Mg from gut. Soft tapwater can lead to low Mg that often geos unrecognised. However Ca and Mg uptake is regulated it is not direct function of   serum 25(OH)D3. Parathormone is importnat fro raising blood Ca and 25(OH)D3 lowers PTH.  The symptoms of hypercalcaemia are known:

https://www.mayoclinic.org/diseases-conditions/hypercalcemia/symptoms-causes/syc-20355523

I doubt that dietary Ca will be limiting. We only absorbe about one third of that ingested.

I take the guesswork out of D3 dosing by measurinf serum25(OH)D3 and aiming for physiological 25(OH)D3 between 100 and 150 nmol/L. Calcium I let look after itself, no tabllets, no diet change. I do take Mg as we have very soft tapwater. 

8000 yars ago in Africa humans would have serum 25(OH)D3 of 100 - 150 nmol/L, almost entirely from sunlight ( no codfish !). UK guidelines allow us a mere 50 nmol/L, and are rarely advised by GPs. To get to 100 nmol/L needs about 2000 IU pd probab;y more in elderly, but it depends upon the individual. Max production from skin  in sun is between 10,000 and 20,000 IU per day. 

Osteoporosis remains unexplained but it is less to do with calcium than other effects on the bone protein matrix. D3 plus Ca doesnt reolve it. Load bearing exercise I have seen mentioned. One for the GP, when its safe.

Peter

Osteomalacia...."adult rickets" ..is curable with D3 supplements, but 25(OH)D3 has to be seriuoslt deficient to cause it.

 

 

Edited by Peter Cobbold
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Wot!  Out of 28 books, five that I know (and that inlcudes the impossible-to-read Stephen King)

No "The Plague" by Camus?

No "A Journal of the Plague Year" by Defoe

No "The Death of Grass" by John Christopher (Sam Youd)

No "The Day of the Triffids" by John Wyndham

Etc., Etc.

The substantial disaster stories vastly overwhelm that paltry list!

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1 hour ago, iain said:

Some more positive press Peter.

http://www.irishhealth.com/article.html?id=27163

Iain

Tks Ian, keep them coming !

That paper is the last one cited in the BMJ rapid response. Oz has far fewer COVID deaths than N Europe because thay are jsut coming out of summer. Beach, barby etc...hence D3

Peter

 

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