Fan Cang Fever Hospitals vs Nightingale Hospitals and the UK Care Home Infection Rate.
When the Chinese Government started their shut down in Wuhan in order to confront the uncontrolled spread of the viral infection via community transmission in public spaces, public transport, work spaces, markets, shopping malls and so forth, they discovered that people self treating at home, in families and in apartment complexes where there are shared areas, lifts, hallways, gardens etc were also spreading the infection and were, within the shut down, the biggest spreaders of infection by every measure.
This is referred to in the WHO final report of February 23rd, and in reports in The Lancet and other news media. We all saw video footage of the build and time-lapse videos of the newly built temporary hospitals. It was a major news story world wide.
Some western media even said it was only possible because the Chinese Government is an Authoritarian Dictatorship, and it couldn't possibly happen in Western democracies. Some people will always attempt to exploit emergent vulnerabilities, or avoid their responsibilities as did some Wuhan officials in the early days of the outbreak.
When the Chinese Authorities and Health Care Officials initiated the shut-down and they were running contact tracing as part of that process they were on a learning curve. That is how they discovered the super spreading nature of self treatment of mild symptoms at home. Family groups with many generations across a number of close by houses, and apartment blocks where many people were moving in and out every day.
Fever Hospitals
In order to resolve that problem, the Chinese health Authorities then moved rapidly to build Fever or Shelter Hospitals to treat every new case presenting with mild symptoms as early as possible, with best available support.
They also set up local community isolation observation wards, for contacts of case traces, where people could be quarantined and observed in order to maximise earliest possible treatment.
They combined these temporary hospitals with extended contact trace, quarantine and isolated treatment programs.
Quarantined contacts were told "as soon as you get symptoms, come to the fever clinics, we will test you for all fever inducing illnesses, just to check. If you have covid19 we will treat you, give you the best support to not go severe/critical." (the Chinese health practitioners used vit c, vit d, chinese herbs, modern medicines and good food and good, consistent care, exercise and social activities to keep morale up.)
This clear advice and logistical support gave the people the security they needed to really engage with the protocol of suppression of transmission leading to eliminating the virus from within the population.
This helped to stop the spread, it reduced the number of cases that progressed to severe or critical, it protected established hospitals from overflow, and it allowed the Chinese authorities to expand already existing ICU from those already existing sites, where it was much easier to train new staff and maintain ICU coverage.
In Wuhan they built 14,000 new bed spaces over a matter of weeks drawing in medical professionals from the Chinese Military and from Hospitals all over China. They also applied the same policy to every local outbreak across China. Because it is an eminently sensible approach to managing this epidemic.
Learning from experience?
Compare this to the UK approach - shutting down the Health System to become a COVDI19 system, ditching all non-elective surgeries, building extra intubation hospitals that were never fully utilised because they were not needed, they were not the appropriate facility for helping to stop the spread of the virus and which were also permanently understaffed. Had the Government studied the Chinese effort and followed that approach, tens of thousands of lives could have been protected.
Whilst at the same time sending thousands of people from hospitals where COVDI19 illness was present, without testing those patients being discharged, in spite of repeated Government assurances that testing would be carried out.
The reckless lunacy of ordering Hospitals to send potentially infectious cases out into the community and into care homes, where they inevitably spread the infection lethal effect - from where more cases lacking supportive treatment went into severe and critical condition, many then needing urgent emergency ICU treatment in NHS hospitals. Many, many thousands died in the care homes without such interventions. Palliative medicine use in care homes surged during those awful months.
When the Chinese Government started their shut down in Wuhan in order to confront the uncontrolled spread of the viral infection via community transmission in public spaces, public transport, work spaces, markets, shopping malls and so forth, they discovered that people self treating at home, in families and in apartment complexes where there are shared areas, lifts, hallways, gardens etc were also spreading the infection and were, within the shut down, the biggest spreaders of infection by every measure.
This is referred to in the WHO final report of February 23rd, and in reports in The Lancet and other news media. We all saw video footage of the build and time-lapse videos of the newly built temporary hospitals. It was a major news story world wide.
Some western media even said it was only possible because the Chinese Government is an Authoritarian Dictatorship, and it couldn't possibly happen in Western democracies. Some people will always attempt to exploit emergent vulnerabilities, or avoid their responsibilities as did some Wuhan officials in the early days of the outbreak.
When the Chinese Authorities and Health Care Officials initiated the shut-down and they were running contact tracing as part of that process they were on a learning curve. That is how they discovered the super spreading nature of self treatment of mild symptoms at home. Family groups with many generations across a number of close by houses, and apartment blocks where many people were moving in and out every day.
Fever Hospitals
In order to resolve that problem, the Chinese health Authorities then moved rapidly to build Fever or Shelter Hospitals to treat every new case presenting with mild symptoms as early as possible, with best available support.
They also set up local community isolation observation wards, for contacts of case traces, where people could be quarantined and observed in order to maximise earliest possible treatment.
They combined these temporary hospitals with extended contact trace, quarantine and isolated treatment programs.
Quarantined contacts were told "as soon as you get symptoms, come to the fever clinics, we will test you for all fever inducing illnesses, just to check. If you have covid19 we will treat you, give you the best support to not go severe/critical." (the Chinese health practitioners used vit c, vit d, chinese herbs, modern medicines and good food and good, consistent care, exercise and social activities to keep morale up.)
This clear advice and logistical support gave the people the security they needed to really engage with the protocol of suppression of transmission leading to eliminating the virus from within the population.
This helped to stop the spread, it reduced the number of cases that progressed to severe or critical, it protected established hospitals from overflow, and it allowed the Chinese authorities to expand already existing ICU from those already existing sites, where it was much easier to train new staff and maintain ICU coverage.
In Wuhan they built 14,000 new bed spaces over a matter of weeks drawing in medical professionals from the Chinese Military and from Hospitals all over China. They also applied the same policy to every local outbreak across China. Because it is an eminently sensible approach to managing this epidemic.
Learning from experience?
Whilst at the same time sending thousands of people from hospitals where COVDI19 illness was present, without testing those patients being discharged, in spite of repeated Government assurances that testing would be carried out.
The reckless lunacy of ordering Hospitals to send potentially infectious cases out into the community and into care homes, where they inevitably spread the infection lethal effect - from where more cases lacking supportive treatment went into severe and critical condition, many then needing urgent emergency ICU treatment in NHS hospitals. Many, many thousands died in the care homes without such interventions. Palliative medicine use in care homes surged during those awful months.
A basic principle of good public health is to learn from the failures and the successes of others facing the same health problem.
Learning from experience, from others failures and their successes.
A number of British and European Public Health professionals issued a report, published in The Lancet on February 19. This is what they said:
"We are public health scientists who have closely followed the emergence of 2019 novel coronavirus disease (COVID-19) and are deeply concerned about its impact on global health and wellbeing. We have watched as the scientists, public health professionals, and medical professionals of China, in particular, have worked diligently and effectively to rapidly identify the pathogen behind this outbreak, put in place significant measures to reduce its impact, and share their results transparently with the global health community. This effort has been remarkable.
We sign this statement in solidarity with all scientists and health professionals in China who continue to save lives and protect global health during the challenge of the COVID-19 outbreak. We are all in this together, with our Chinese counterparts in the forefront, against this new viral threat."
The WHO were in country in China, and were in the process of taking evidence for a final report on the Wuhan situation at the same time. They were in China between 14th and 24rd of February, and this is from their final report.
"Achieving China’s exceptional coverage with and adherence to these containment measures has only been possible due to the deep commitment of the Chinese people to collective action in the face of this common threat.
At a community level this is reflected in the remarkable solidarity of provinces and cities in support of the most vulnerable populations and communities. Despite ongoing outbreaks in their own areas, Governors and Mayors have continued to send thousands of health care workers and tons of vital PPE supplies into Hubei province and Wuhan city.
At the individual level, the Chinese people have reacted to this outbreak with courage and conviction. They have accepted and adhered to the starkest of containment measures – whether the suspension of public gatherings, the month-long ‘stay at home’ advisories or prohibitions on travel.
The WHO were in country in China, and were in the process of taking evidence for a final report on the Wuhan situation at the same time. They were in China between 14th and 24rd of February, and this is from their final report.
"Achieving China’s exceptional coverage with and adherence to these containment measures has only been possible due to the deep commitment of the Chinese people to collective action in the face of this common threat.
At a community level this is reflected in the remarkable solidarity of provinces and cities in support of the most vulnerable populations and communities. Despite ongoing outbreaks in their own areas, Governors and Mayors have continued to send thousands of health care workers and tons of vital PPE supplies into Hubei province and Wuhan city.
At the individual level, the Chinese people have reacted to this outbreak with courage and conviction. They have accepted and adhered to the starkest of containment measures – whether the suspension of public gatherings, the month-long ‘stay at home’ advisories or prohibitions on travel.
Throughout an intensive 9-days of site visits across
China, in frank discussions from the level of local community mobilizers and frontline
health care providers to top scientists, Governors and Mayors, the Joint Mission was
struck by the sincerity and dedication that each brings to this COVID-19 response."
and
"China’s bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic. A particularly compelling statistic is that on the first day of the advance team’s work there were 2478 newly confirmed cases of COVID-19 reported in China. Two weeks later, on the final day of this Mission, China reported 409 newly confirmed cases. This decline in COVID-19 cases across China is real."
This begs the question - Why did the UK Government, SAGE and Public Health England ignore the experience and learning from real lived social and material data and evidence from the Chinese handling of the epidemic?
Herd Immunityand
"China’s bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic. A particularly compelling statistic is that on the first day of the advance team’s work there were 2478 newly confirmed cases of COVID-19 reported in China. Two weeks later, on the final day of this Mission, China reported 409 newly confirmed cases. This decline in COVID-19 cases across China is real."
This begs the question - Why did the UK Government, SAGE and Public Health England ignore the experience and learning from real lived social and material data and evidence from the Chinese handling of the epidemic?
The UK Government made deliberate choices to not do that, to not learn from the experience of others and what is worse is that they created novel policies that exacerbated the spread of the infection, that led to more deaths than if they had adopted and adapted the public health protocols that were already proven to work so well.
At every stage, the UK Government has avoided what works, and pushed policies that have failed, repeatedly. The UK Government has also lie about the data, the evidence, their actions and outcomes. This all goes beyond mere incompetence. The only logical assumption is that the UK Government's initial stance of 'herd immunity' still stands and is being defended with every step, using every tool in the Governments hands.
'Herd Immunity' on their terms is reached when 60% of population have been infected - the claim is at that level of infection the entire population is protected from a second wave next winter.
The price to be paid is 400,000 excess deaths or early deaths of already ill people. The price to be paid is the destruction of small business in favour of corporate business. The price to be paid is mass unemployment.The price to be paid is destruction of self-employment within the UK. The price to be paid is multiple waves of infection surges, a punishing cycle of shut-down, open up, shut-down, open up.
Care Homes
In the UK NHS hospitals were turning away people presenting with mild yet uncomfortable symptoms, which were sent back home to self treat. I have heard and been part of a few anecdotal stories of people I know whose relatives were quite ill, did the phone consultation, went into hospital, were checked, and given a confirmed, non-tested diagnosis and sent home to self treat. One case I know of through family connections was an elderly male, with severe chest pains who was prescribed opiates for the pain, and then sent home to self isolate. Fortunately he has recovered. His family remain well.
Likewise there are plenty of cases of elderly patients who were known to have the infection and were were sent back to care homes. Both of these were policies decided by Government and NHS senior management. Both led to exacerbation of symptomatic cases and excess deaths in many cases.
11,500 deaths and rising with the UK Care home systems, and we have no way of accounting for the numbers of excess deaths from people who died at home, or who went from home to intensive care, having been sent home with symptoms in the first place.
There are questions that must be asked, and answered. Incompetence is one thing, callous indifference another.
We deserve much, much better. The vulnerable people within the UK Health systems, private and public alike deserved much more than merely better - they deserve the fullest logistical and human resourced protections possible. It cannot be a matter of budget if as a State this state is also considering 250 billion spend on it's Nuclear 'Deterrent'.
Kindest regards
Corneilius
"Do what you love, it is your gift to universe."
