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Why is 300,000 beds good and 141,000 bad? Why not 600,000 or 900,000 beds? We could fill them once again with thousands having unnecessary Tonsillectomy  ops along all the outdated and ineffective treatments than we were assured were vital to the health of the nation.

I suppose we also need to increase the army from its present size of 80,000 to the 247,000 we had in WW1 just in case irrespective of the cost, and we have far fewer wheelwrights than we used to what if we need lots of carriage wheels and the Chinese can't supply?

Might need to adjust the budget in order to keep a bloated unused resource on tap forever. Surely better to keep a number equivalent to the load and take on new capacity as required.

Fings Ain't Wot They Used T'be,

 Alan

 

 

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26 minutes ago, john.r.davies said:

And on the VitD front (and I mean Front!) PeterC's heartfelt advocacy and deep research echoes, I fear that of Linus Pauling, one of the few double Nobel Laureates (Chemistry and Peace) for megadoses of Vitamin C as prophylaxis and treatment of the common cold (Ironically, the other corona virus).     His regime was 3 GRAMS a day (normal requirement, about 100mgs, or thirty times less) and 10 GRAMS if you fell ill.   The concept is no longer considered reasonable.

That such a pre-eminent scientist could be mistaken is just part of science.    Pauling saw his evidence pointing that way, and followed it.     No doubt we will hear more evidence about Vit D.   The Birmingam paper is, again, just part of science, that has no absolute truth to sell.       

Unlike Pauling who was a solitary voice, D3 and its many actions has 5000 research papers per year delving into its actions. Unlike vitamin C, D3 is not a vitamin its a hormone controling several hundred genes.

I regard VitC as dangerous - it can be a pro-oxidant as well as anti  - and stick religiously to the RDA.

Science is never about absolute truth, but does aim to reduce as far as possible the probabilty of being wrong. To do that the whole body of knowledge has to be embraced, the evidence muust never exclude any approach to understanding. NICE D3 panel fails to conform to that criterion and is going to be disgraced.

Peter

Peter

 

 

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2 hours ago, john.r.davies said:

 

image.png.b272106a4d0ce3015619dc868665f2cd.png

I like to think this is not the time for more of Labour v Conservative achievement. If you wish to look at the graft you provided It seems from

1997 - 2010 

200,000 to 151,000 loss of 49,000 beds. Ave loss 3700 per annum 

2010 - 2020 

151,000 to 141,000 loss 10,000 beds. Ave loss 1,000 per annum

Perhaps it’s not the time to be pointing fingers about NHS. 

 

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"How did a country with an international reputation for public health get it so wrong?”

Not me, not a political statement, that's the opinion of the Editorial in the British Medical Journal, published 15/5/2020.    There's nothing overaly medical there, just hard-hitting journalism:

https://www.bmj.com/content/369/bmj.m1932

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"How did a country with an international reputation for public health get it so wrong?”

Do/did we have such a reputation? I am not so sure that even if we did it would be deserved.

Yes much is good within the NHS but it simply is not a National Health Service, it is a National Sickness Service, it treats the ill and the damaged but what it does not do is ensure that our people are healthy, which would reduce the treatment workload.

To list but a few, What does the NHS do about stopping obesity in the country (guilty) - nothing, about promoting exercise – nothing, about Vit D levels which seems to have myriad problems associated with low levels – nothing. Written from my lifetime experience as a member of the public, and those of my relatives and acquaintances.

Yes there is the vaccination program which has made massive differences to serious illnesses but from my experience as a member of the public the NHS does not go further and actively promote health, which I thought was the original dream for a “fit and healthy workforce”. I do not look on the world through rose tinted glasses I know such a utopian involvement would be difficult to manage in the real world but why does not the NHS at least establish such practices within their own workforce? As an example we hear, might be rumour, of NHS staff with low VitD serum levels - why? As in Luke 4:23  “ Physician heal thyself”  why should any patient presenting to his doctor with some symptoms trust any doctor who had similar treatable, but untreated issues? 

The NHS should lead by example, it should promote well-being throughout its workforce, its staff should be the embodiment of a healthy lifestyle and become what it has almost never been; a National Health Service.

By promote I do not mean a few posters and a TV advert or two!

Alan

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Enforced fitness - an Orwellian nightmare indeed. 

They have done it with cigarettes don't forget - and there are those who want to do it with alcohol and meat too. What next - cream buns and doughnuts?  Compulsory gym sessions? Where do you stop such state-intrusion into your life?

Not a world I would want to live in.  

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11 minutes ago, RobH said:

Enforced fitness - an Orwellian nightmare indeed. 

They have done it with cigarettes don't forget - and there are those who want to do it with alcohol and meat too. What next - cream buns and doughnuts?  Compulsory gym sessions? Where do you stop such state-intrusion into your life?

Not a world I would want to live in.  

Rob,

Why is it that a minority group with a big mouth seem to manage to have their views enforced into everyone ?

Never ceases to amaze me how they manage to wriggle into positions of power and install fear if anyone disagrees with their secular views......and yet they do !!

If anyone messes with my choccie oaties.......I may be forced to write a letter to the Times !!

 

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9 hours ago, john.r.davies said:

"How did a country with an international reputation for public health get it so wrong?”

Not me, not a political statement, that's the opinion of the Editorial in the British Medical Journal, published 15/5/2020.    There's nothing overaly medical there, just hard-hitting journalism:

https://www.bmj.com/content/369/bmj.m1932

 

Not a political statement John, yes, but, there is still an assumed truth, which is a dangerous premise for any arguement

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13 hours ago, Peter Cobbold said:

Unlike Pauling who was a solitary voice, D3 and its many actions has 5000 research papers per year delving into its actions. Unlike vitamin C, D3 is not a vitamin its a hormone controling several hundred genes.

I regard VitC as dangerous - it can be a pro-oxidant as well as anti  - and stick religiously to the RDA.

Science is never about absolute truth, but does aim to reduce as far as possible the probabilty of being wrong. To do that the whole body of knowledge has to be embraced, the evidence muust never exclude any approach to understanding. NICE D3 panel fails to conform to that criterion and is going to be disgraced.

Peter

Peter

 

 

Peter, well said!

Your reflections remind me of Alfred Kuhn's exposing the behind-the-scenes squabbling during "paradigm shifts" The Structure of Scientific Revolutions (1962).

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11 hours ago, john.r.davies said:

"How did a country with an international reputation for public health get it so wrong?”

Not me, not a political statement, that's the opinion of the Editorial in the British Medical Journal, published 15/5/2020.    There's nothing overaly medical there, just hard-hitting journalism:

https://www.bmj.com/content/369/bmj.m1932

Interesting article. Their analysis of what has happened to date triangulates with much else I have read. PHE certainly seems to have been ill-conceived and equipped for the massive role thrust onto it. At the same time, it could and should never have been expected to have the logistical expertise or capacity, or authority, to lead and coordinate the necessary ramp-up of resources on testing that was required. That needed swift and effective management action at DHSC level, directed by ministers, which appears to have been largely absent.

Looking to the immediate future, it's axiomatic in practical management of major emergencies that you absolutely must create the capacity for the anticipated next phase while you are still managing the current one. It's not easy (been there, in minor roles) but it's crucial. In this emergency, it's been clear for many weeks that the test-trace-isolate organisational infrastructure and capacity would need to be up and running as soon as lockdown is started to ease. God only know why it's taking so long to establish, given the 'battle winning' importance of that capability. And I also suspect the BMJ is right that the system needs to be locally coordinated - that was a key lesson from the first, unsuccessful, attempts at contact tracing in Sierra Leone in the ebola outbreak.

Nigel

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RobH,

No not Enforced fitness, but wouldn't you like to know if you or your children are short of Selenium, Zinc, Vit D and other such important minerals /vitamins that are becoming scarcer in our food? Something that you could easily correct at minimum cost and effort. If you try and get such a test from the NHS they resist, they even insult you with the sneering term "worried well" and all you want is to ensure that you have no deficiencies that detrimentally effect your health.

Proactive healthcare. 

Alan

 

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19 minutes ago, barkerwilliams said:

RobH,

No not Enforced fitness, but wouldn't you like to know if you or your children are short of Selenium, Zinc, Vit D and other such important minerals /vitamins that are becoming scarcer in our food? Something that you could easily correct at minimum cost and effort. If you try and get such a test from the NHS they resist, they even insult you with the sneering term "worried well" and all you want is to ensure that you have no deficiencies that detrimentally effect your health.

Proactive healthcare. 

Alan

 

Alan, I wholeheartedly agree. I suspect nutrition is still a backwater in undergrad medical courses and that pervades the profession, D3 along with trace elements has fallen into the nutrtion quicksand to the point where Prof Holick a lifelong, eminent clinicin-researcher reckoned it was more importnat for him to publish in womens and health magazines that in Lancet, NEJM or other prestgioous journals. Peter 

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2 hours ago, DavidBee said:

Peter, well said!

Your reflections remind me of Alfred Kuhn's exposing the behind-the-scenes squabbling during "paradigm shifts" The Structure of Scientific Revolutions (1962).

David, Kuhn's book is on my shelves but so far unread, sad to say. Biology raises few paradigm conflicts, it is too complex to  reduce to either/or questions. Evolution yes/no was an exception..Physics is another matter, largeyl due to the roles given to theory. Theory in biology is thin on the ground compared with observation and experiment, and takes a back seat. The problem with biology is handling the huge breadth of data to generate understanding. Our squabbles are of interpretation: which results carry more weight than others. And that is what is happening with D3.- some of us are taking a much wider sweep of the available science than others. When D3 science is accepted by the medical establishment there will be a paradigm shift of sorts, towards a D3 repelte healtiier population with a much lower incidence of chronic diseases. But I dont see a Kuhnian  squabble between scientists, More a realisation by medical authoririties that simplfying D3 advice by imposing RCTs has been a disaster. Biology of D3 is vastly more complex than assessing a drug. Peter

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7 hours ago, barkerwilliams said:

"How did a country with an international reputation for public health get it so wrong?”

Do/did we have such a reputation? I am not so sure that even if we did it would be deserved.

Alan

Yes, we did.  The Global Health Security Index rated the UK as second out of 135 assessed countries, second only to the USA.

See:  https://www.ghsindex.org/

But this only shows how much the political leadership, or lack of it, can screw up any health planning.     New York by the 1st May had 279 deaths/100K population from Covid, with a tenth of that over the whole country.   Compare, over whole countries, and excepting variation in counting methods, the UK at 50 and Beklgium at 77/100K.

New Zealand, which was rated at 35th in preparedness by GSHI, has had 21 deaths.   In total, with only 1500 cases.    With nearly five million people in NZ that's as good as NO infections and NO deaths.

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12 minutes ago, john.r.davies said:

Yes, we did.  The Global Health Security Index rated the UK as second out of 135 assessed countries, second only to the USA.

See:  https://www.ghsindex.org/

But this only shows how much the political leadership, or lack of it, can screw up any health planning.     New York by the 1st May had 279 deaths/100K population from Covid, with a tenth of that over the whole country.   Compare, over whole countries, and excepting variation in counting methods, the UK at 50 and Beklgium at 77/100K.

New Zealand, which was rated at 35th in preparedness by GSHI, has had 21 deaths.   In total, with only cases.    With nearly five million people in NZ that's as good as NO infections and NO deaths.

NZ is coming out of summer so the virus is trying to infect a D3-replete population, and failing. https://livrepository.liverpool.ac.uk/3084575/

Their crunch will come soon as D3 levels decline. UK will see fewer until winter.

If the epiemiologists do not latch on to D3 and decide to follow "successful" nations' policies thay will screw up. We human petri dishes can be very different seasonally.

In europe the link with D3 reflects national awareness of its importance, highest in Scandinavia: graph p3:

http://imj.ie/vitamin-d-and-inflammation-potential-implications-for-severity-of-covid-19/  

Finns Swedes amd Norwegians have to supplement to get through long winters, and are spared covid better than sun-shy Spaniards.

Peter

 

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39 minutes ago, john.r.davies said:

Yes, we did.  The Global Health Security Index rated the UK as second out of 135 assessed countries, second only to the USA.

See:  https://www.ghsindex.org/

But this only shows how much the political leadership, or lack of it, can screw up any health planning.     New York by the 1st May had 279 deaths/100K population from Covid, with a tenth of that over the whole country.   Compare, over whole countries, and excepting variation in counting methods, the UK at 50 and Beklgium at 77/100K.

New Zealand, which was rated at 35th in preparedness by GSHI, has had 21 deaths.   In total, with only 1500 cases.    With nearly five million people in NZ that's as good as NO infections and NO deaths.

 

John

Spoke to my brother in Sydney today, he attributes Australia's situation to the forest fires of last year.

These put a massive brake on the arrival of visitors from Asia, just as CV19 was taking hold there.

This, combined with the timing of lockdown, hardening of patrols to stop illegal coastal landings and the closure of their external borders, means that very few cases got into the country.

There is still a ban on travel between states, even though the lockdown has been relaxed to the point where bro and his other half were having coffees at a cafe last week.

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5 hours ago, Peter Cobbold said:

Our squabbles are of interpretation: which results carry more weight than others.

That's what Kuhn's on about.

It is only applied theory or a posteriori theory, based on empirical obswrvation of patterns in science.

I also read his later bits and bobs, just to see how his ideas developed.

He is mostly misunderstood or not read at all. Cited for what he doesn't say.

I'd say there's nothing either or in his contribution. He sheds light on what a mess science is, contrary to popular perception.

Complexity theory came later, but it is apparent in his writing.

Far from being a highly developed text, finely honed, it's messy. I think you will enjoy it. I did. Coming from a continental background or forma mentis, I must say I felt a little let down he didn't recast his ideas in a more systematic way. But in a sense that is also what's reassuring.

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John (WGCO), NEW ZEALAND, not Oz. although the Aussies have been as fortunate.

Peter, In Oz, and NZ, the 'epidemic' of skin cancer in a largely white population of a partly tropical country has led to the "Slip, Slap, Slop" campaign, a culture of avoiding the sun, and the wide use of Factor 50 sun cream.  New Zealand straddles 40 degrees south, approximately the same position 'sun-wise' as Spain.       The Spaniards didn't benefit much from their solar Vit D, did they?   Or was it all those siestas?

image.png.52f7a91415ec77f027b07be5fc12bfa6.png

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1 hour ago, john.r.davies said:

John (WGCO), NEW ZEALAND, not Oz. although the Aussies have been as fortunate.

Peter, In Oz, and NZ, the 'epidemic' of skin cancer in a largely white population of a partly tropical country has led to the "Slip, Slap, Slop" campaign, a culture of avoiding the sun, and the wide use of Factor 50 sun cream.  New Zealand straddles 40 degrees south, approximately the same position 'sun-wise' as Spain.       The Spaniards didn't benefit much from their solar Vit D, did they?   Or was it all those siestas?

image.png.52f7a91415ec77f027b07be5fc12bfa6.png

John ,  I dony know why Spain and Italy have such low D3 but they were coming out of winter. Whereas NZ and Oz were at end of summer when coronanvirus appeared.

Sun lotion is rarely applied thick enough to prevent all D3 synthesis, but slip-slap-slop will have contributed to global pandemic of D3 deficiency.  D3 deficiency is a major risk factor for

skin cancer, so I prefer to take supplements and top up with a bit of sunshine.  In a survey of Oz dermatlogists three quarters were d3-deficient, at at higher risk of melanoma etc !!

Brazil will be interesting - no controls on socialising and lots of sun for those that cannot afford take refuge in air-con housing. Africa too. In a psot hoc analysis of the pandemic those continents may provide convincing evidemce for D3 protecting  against the virus, through sun. The sheltered rich die, the sun drenched poor shrug it off.

Peter

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2 hours ago, DavidBee said:

That's what Kuhn's on about.

It is only applied theory or a posteriori theory, based on empirical obswrvation of patterns in science.

I also read his later bits and bobs, just to see how his ideas developed.

He is mostly misunderstood or not read at all. Cited for what he doesn't say.

I'd say there's nothing either or in his contribution. He sheds light on what a mess science is, contrary to popular perception.

Complexity theory came later, but it is apparent in his writing.

Far from being a highly developed text, finely honed, it's messy. I think you will enjoy it. I did. Coming from a continental background or forma mentis, I must say I felt a little let down he didn't recast his ideas in a more systematic way. But in a sense that is also what's reassuring.

The point where biological complexity cannot be redced to a level that humans can grasp, either alone or as groups, cannot be far off. Quite apart from "conciousness" the immune system must be getting close. I happened upon a computerised database the other day, for immune resolution. https://www.biorxiv.org/content/10.1101/2020.01.27.921882v1.full.pdf

Cancer signalling pathways are another example: https://en.wikipedia.org/wiki/MAPK/ERK_pathway#/media/File:MAPKpathway.jpg

I can see much squabbling to come.!!

Peter

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7 hours ago, wjgco said:

 

John

Spoke to my brother in Sydney today, he attributes Australia's situation to the forest fires of last year.

These put a massive brake on the arrival of visitors from Asia, just as CV19 was taking hold there.

This, combined with the timing of lockdown, hardening of patrols to stop illegal coastal landings and the closure of their external borders, means that very few cases got into the country.

There is still a ban on travel between states, even though the lockdown has been relaxed to the point where bro and his other half were having coffees at a cafe last week.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1940076/

Seasonal dip in 25(OH)D3

Worst in Tasmania. I have no idea where Geeelong is., somewhere between Tasmania and Queensland. (and men  are in short supply it seems)

In Geelong in winter UVB plunges (line of  dots) and D3 insufficiency rises to peak in Sept, starting about now

image.png.f1cd76407f807fb6917e84a9f8a0a758.png

 

25(OH)D3 dips to 50nmol/L from summer high of 90.

image.png.8e38aa20fc2f889534ca5ea051dbe301.png

 

 

Risk fo severe Covid in other countries rose below 75 nmol/L, so Geelong is below that level (on average) from June to Nov.

But half the population are lower than 75.

Peter

Edited by Peter Cobbold
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13 hours ago, Peter Cobbold said:

 The sheltered rich die, the sun drenched poor shrug it off.

Peter

That doesn't seem to be the story here, and elsewhere.   Poverty is a significant factor in the mortality form CV19.

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20 minutes ago, john.r.davies said:

That doesn't seem to be the story here, and elsewhere.   Poverty is a significant factor in the mortality form CV19.

Yeah and they do "tapps aff" in Glasgow any time the sun peeps oot. No heliophobes them.

:D

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