# Peak of the virus



## elacsaplau

What precisely does this mean?


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## john luc

I presume that the number of new infections stop rising per day. there will still be people turning up as infected but less per week than previous weeks


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## llgon

In the context of what was said by the Chief Operations Officer of the HSE today?

This is the quote from the journal.ie:

“We do have to work on some basis when it comes to planning and we are planning for a peak between the 10 and 14 April, around that time.”

So from that point of view I would think it means when the HSE and hospitals are at their busiest. However, I don't think it's entirely clear.


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## Brendan Burgess

A very good question and this is my understanding of it: 

There are a few different peaks

1) The peak of new infections after which the numbers of new infections begins to fall

2) The peak in hospital admissions which is probably the one worrying the HSE the most.  This is probably 10 days after the first peak
2A) The peak numbers in intensive care 

3) The peak in deaths which is probably a few days later again 

So when new cases begin to fall and the long-term outlook is improving, the numbers of deaths will continue to rise for a while.

Brendan


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## john luc

the important number I think will be the rate of new infections.  if this starts to fall then we can see a way ahead for all the other numbers to reach a total number.


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## Brendan Burgess

There are 200  new cases today.  Update: 295 cases on Monday 30th 

That is "only" an 8% increase.


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## joe sod

and its not rising exponentially therefore the measures to contain it are definitely working, there is still a long way to go though


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## Susie2017

Id be wary about interpreting numbers of positives over the weekends. Generally there are only a couple of scientists on call ( in hospital laboratories anyway). Also there is a very large backlog of swabs so these numbers may refer to some cases that were swabbed a week ago. I missed the news was there any mention of daily Lab capacity or turnaround times ?


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## Eireog007

Susie2017 said:


> Id be wary about interpreting numbers of positives over the weekends. Generally there are only a couple of scientists on call ( in hospital laboratories anyway). Also there is a very large backlog of swabs so these numbers may refer to some cases that were swabbed a week ago. I missed the news was there any mention of daily Lab capacity or turnaround times ?



Id be very surprised if the labs are not running a full compliment each and every day during a virus pandemic.


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## Sunny

Susie2017 said:


> Id be wary about interpreting numbers of positives over the weekends. Generally there are only a couple of scientists on call ( in hospital laboratories anyway). Also there is a very large backlog of swabs so these numbers may refer to some cases that were swabbed a week ago. I missed the news was there any mention of daily Lab capacity or turnaround times ?



Yes there are only a couple of people on call in the labs. The unions have also demanded 2 hour lunch breaks and nobody is to work weekends. Are we seriously going to allow people peddle any unfounded rubbish?


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## mathepac

According to news media contacts, the information given at press conferences is as of mid-day the the day before the press briefing. I think that makes it doubly difficult if not impossible for Sean & Sheila citizen to recognize a peak or forecast one, whatever kind the peak is. 

For me the peak is when there are no new diagnoses of the virus and when the last person diagnosed as infected either dies or recovers to a stage where they are no longer infective.


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## mathepac

Sunny said:


> The unions have also demanded 2 hour lunch breaks and nobody is to work weekends.


There is a testing backlog in the middle of a pandemic. What about statutory meal breaks and week-end overtime? This is a crisis what about the Beloved Leader weilding his emergency powers baton? What about underemployed technicians and scientists in 3rd level institutions, set up 24 hour rotas?


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## Brendan Burgess

Part of the low count today may be due to the lack of testing kits. 









						Páirc Uí Chaoimh testing centre closes due to lack of kits
					

Country’s largest coronavirus testing facility due to reopen on Monday, says HSE




					www.irishtimes.com


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## elacsaplau

OP here - thanks for the comments.

Here's where I'm at
1. We talk about the peak but we don't know what it means.
2. Even if we knew what it means, we may not have much of a clue when we are there because of deficiencies in the testing regime (i.e. a limit on the amount of tests, the delay in the test results, the fact that very many suspected cases are not even being tested and that people could carry the virus but be non-symptomatic, etc.)

Apart from the above, I'm struggling to understand:
1. Why the HSE suggested today that the peak may be in c. 2 weeks time?
2. How many people are expected to have the virus in total - remember the non-disputed figure of 40% of the population of a few weeks back, has that gone by the wayside?


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## Sophrosyne

elacsaplau, you are asking questions that, if they are honest, no one can answer.

This is a new virus and modelling by its nature is approximate and dependent on several factors.


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## noproblem

How can anyone talk about a peak when there's no cure for the virus? Ok, people can talk about it, but it's total speculation what's being said.


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## Susie2017

Medical Laboratory Scientists in the main work 8  - 6 mon - fri. Outside if that its on call. On call is rostered and not all scientists choose to be rostered for on call duties. You cant go on call unless you have additional training in the on call area required. Testing requires kits, reagents and a platform plus staff to work it. If theres a backlog then any one of these could be the reason for reduced turnaround times.


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## mathepac

Faster than they would like, the Government's Great Coronavirus Pandemic Response Plan, GGCPRP is unravelling.


Not enough kits to to take swabs
Announcements for orders for 55,000 new sample kits. That's about enough to test 0.012% of the population once. And sure no-one will need to be tested more than once.
New swabbing centres set up remote from testing centres - no logistics planners available to Leo, Holohan & Co?
Queues and delays for swabbing for infections and testing the swabs grow longer
Testing reagents run out in at least one testing centre
Industrialist disputes the number of respirators / ventilators produced by Medtronics in Galway - IDA says 50% of world-wide ICU demand, industrialist, a supplier to Medtronics, says 10%. No one knows how many we'll need
Government announces two-week lockdown, UK scientist says their lockdown must last until June
Lab technicians' union insists on a work-to-rule
I'm sure I've missed loads, ICU beds, the stupid yellow booklet and so on. 

Please explain how those most vulnerable in our society will survive this pandemic and how anyone can identify the peak?


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## Leper

mathepac said:


> Faster than they would like, the Government's Great Coronavirus Pandemic Response Plan, GGCPRP is unravelling.
> 
> 
> Not enough kits to to take swabs
> Announcements for orders for 55,000 new sample kits. That's about enough to test 0.012% of the population once. And sure no-one will need to be tested more than once.
> New swabbing centres set up remote from testing centres - no logistics planners available to Leo, Holohan & Co?
> Queues and delays for swabbing for infections and testing the swabs grow longer
> Testing reagents run out in at least one testing centre
> Industrialist disputes the number of respirators / ventilators produced by Medtronics in Galway - IDA says 50% of world-wide ICU demand, industrialist, a supplier to Medtronics, says 10%. No one knows how many we'll need
> Government announces two-week lockdown, UK scientist says their lockdown must last until June
> Lab technicians' union insists on a work-to-rule
> I'm sure I've missed loads, ICU beds, the stupid yellow booklet and so on.
> 
> Please explain how those most vulnerable in our society will survive this pandemic and how anyone can identify the peak?



The last thing we need at this time is  cynical cynicism (and that's from the most leprous cynic in Christendom).

1. For a start the Yellow Booklet was not stupid. It was sent to every home to assist during the pandemic. I bet if the booklet was not sent, you'd be complaining too.

2. OK! We ran out of test kits. The HSE used what it had and didn't store them. I understand new test kits will be available in every test centre today.
3. We haven't time for full logistical planning. Newsflash! We're in a pandemic.
4. Yes there are queues for swabbing. Such is the nature of the beast every hypochondriac in the country thinks he's infected.
5. Leo Varadkar is not Genie, he just can't blink and have plentiful supply of ventilators etc at the end of Larry Hagmans bed.
6. The government has imposed a near lockdown for two weeks. It was not suggested that it would last for this period only.
7. I don't know what you are talking about re "Lab technicians' union insisting on a work-to-rule.
8. The HSE is doing as well as it can with ICU beds. The private hospitals have come in with HSE on this one. In other words the country is doing as best it can.
9. Our borders may close shortly. 
10. Things will get much worse and the last thing the country needs is abject cynicism.

I predict that before this pandemic is over in the rest of europe that it will be well over in Ireland. I predict we will be taking Covid-19 patients from other countries for hospitalisation here. Let's stop knocking our own for a change.


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## Eireog007

mathepac said:


> Faster than they would like, the Government's Great Coronavirus Pandemic Response Plan, GGCPRP is unravelling.
> 
> 
> Not enough kits to to take swabs
> Announcements for orders for 55,000 new sample kits. That's about enough to test 0.012% of the population once. And sure no-one will need to be tested more than once.
> New swabbing centres set up remote from testing centres - no logistics planners available to Leo, Holohan & Co?
> Queues and delays for swabbing for infections and testing the swabs grow longer
> Testing reagents run out in at least one testing centre
> Industrialist disputes the number of respirators / ventilators produced by Medtronics in Galway - IDA says 50% of world-wide ICU demand, industrialist, a supplier to Medtronics, says 10%. No one knows how many we'll need
> Government announces two-week lockdown, UK scientist says their lockdown must last until June
> Lab technicians' union insists on a work-to-rule
> I'm sure I've missed loads, ICU beds, the stupid yellow booklet and so on.
> 
> Please explain how those most vulnerable in our society will survive this pandemic and how anyone can identify the peak?



The entire world is currently working with a restricted number of test kits and you’re referring to one test site out of 44 which was down for less than a day.
55,000 would cover 1.2% of the population I think you’ve misread your calculator there. Also we need enough tests to cover the potentially infected population not the entire population.
It is far easier to set up swabbing locations to easily cover all of the country than have everybody drive to the smaller number of testing labs which is also the more efficient way to collect as many samples as possible.
Have you any numbers to back up this claim? The number of tests being checked is increasing every day and the new criteria has restricted the number of people being checked.
Covered in my point above, the centre at Parc Ui Coaimh was down for half a day and will be back operational today.
Government body says one thing vs one unnamed source. Again do you have any sources with any details at all? Once again no country in the world has an exact idea of how many ventilators they will need but we somehow should.
Once again one person making a claim (it may be accurate). The UK government also initially stated their lockdown would only last a number of weeks. It’s almost as if no government can predict when the peak of infections will hit and don’t want to tell everybody that they will be locked down for months on end as they are afraid of unrest and a drop in public engagement. It’s also possible that they are adjusting their response to an unprecedented situation as new information comes in. Shocking I know.
Once again please provide any proof at all of this and how it will negatively effect testing.
Try sticking to facts please and not half truths/completely unsubstantiated rumours from Whatsapp etc.


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## Eireog007

Brendan Burgess said:


> Part of the low count today may be due to the lack of testing kits.
> 
> 
> 
> 
> 
> 
> 
> 
> 
> Páirc Uí Chaoimh testing centre closes due to lack of kits
> 
> 
> Country’s largest coronavirus testing facility due to reopen on Monday, says HSE
> 
> 
> 
> 
> www.irishtimes.com



Due to the time it takes to gather, transport and test these kits I would say it’s unlikely that the results from yesterday were affected at all. Today/Tomorrow is more likely to see any potential skewed figures and one site from 44 down is unlikely to throw off the numbers hugely.


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## EmmDee

mathepac said:


> For me the peak is when there are no new diagnoses of the virus and when the last person diagnosed as infected either dies or recovers to a stage where they are no longer infective.



That, by definition, is the end of the outbreak. A "peak" is the highest number - not the lowest

As mentioned, there are probably three "peaks" which are distinct but related - number of infected, number hospitalised / ICU, number of deaths. If you're looking at managing scarce resources (hospital beds, ICU resources, staffing availability), the relevant peak is hospitalisation - that's what they are trying to manage


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## noproblem

Leper said:


> I predict that before this pandemic is over in the rest of europe that it will be well over in Ireland. I predict we will be taking Covid-19 patients from other countries for hospitalisation here. Let's stop knocking our own for a change.


Now, that's a WOW! I really do pray that your prediction doesn't happen.


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## Laramie

Is the government projecting the peak as being two weeks from the lockdown?


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## Leo

Susie2017 said:


> Id be wary about interpreting numbers of positives over the weekends. Generally there are only a couple of scientists on call ( in hospital laboratories anyway).



There's one in my extended family, no test outstanding there yesterday anyway, but that was more down to centres running out of kits that staffing levels.


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## Purple

Eireog007 said:


> The entire world is currently working with a restricted number of test kits and you’re referring to one test site out of 44 which was down for less than a day.
> 55,000 would cover 1.2% of the population I think you’ve misread your calculator there. Also we need enough tests to cover the potentially infected population not the entire population.
> It is far easier to set up swabbing locations to easily cover all of the country than have everybody drive to the smaller number of testing labs which is also the more efficient way to collect as many samples as possible.
> Have you any numbers to back up this claim? The number of tests being checked is increasing every day and the new criteria has restricted the number of people being checked.
> Covered in my point above, the centre at Parc Ui Coaimh was down for half a day and will be back operational today.
> Government body says one thing vs one unnamed source. Again do you have any sources with any details at all? Once again no country in the world has an exact idea of how many ventilators they will need but we somehow should.
> Once again one person making a claim (it may be accurate). The UK government also initially stated their lockdown would only last a number of weeks. It’s almost as if no government can predict when the peak of infections will hit and don’t want to tell everybody that they will be locked down for months on end as they are afraid of unrest and a drop in public engagement. It’s also possible that they are adjusting their response to an unprecedented situation as new information comes in. Shocking I know.
> Once again please provide any proof at all of this and how it will negatively effect testing.
> Try sticking to facts please and not half truths/completely unsubstantiated rumours from Whatsapp etc.


We are testing 5000 a day. The UK are testing 10,000 a day.
There are now two groups of people in Ireland;
1) Healthcare sector workers and those sourcing, supplying and making equipment to support their efforts. That includes tests, PPE and Ventilators as well as a myriad of other stuff that we don't think of.
2) Everyone else.

The most important group is the second group. They are the proactive group. It is they who will determine whether the first group is overwhelmed by this disease. Their actions, and not those of the first group, will decide how many people die. 
If the second group don't  do their part then it doesn't matter how many ICU beds, Ventilators or tests we have. 

The first group is the reactive group. They will react to the actions of the second group. They are hostages to fortune but they will suffer the brunt of the effects of this crisis.


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## Eireog007

Purple said:


> We are testing 5000 a day. The UK are testing 10,000 a day.
> There are now two groups of people in Ireland;
> 1) Healthcare sector workers and those sourcing, supplying and making equipment to support their efforts. That includes tests, PPE and Ventilators as well as a myriad of other stuff that we don't think of.
> 2) Everyone else.
> 
> The most important group is the second group. They are the proactive group. It is they who will determine whether the first group is overwhelmed by this disease. Their actions, and not those of the first group, will decide how many people die.
> If the second group don't  do their part then it doesn't matter how many ICU beds, Ventilators or tests we have.
> 
> The first group is the reactive group. They will react to the actions of the second group. They are hostages to fortune but they will suffer the brunt of the effects of this crisis.



Hey Purple, not sure why you quoted my message there, are you responding to one of my points?


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## mathepac

Eireog007 said:


> Once again please provide any proof at all of this and how it will negatively effect testing.
> Try sticking to facts please and not half truths/completely unsubstantiated rumours from Whatsapp etc.


Yesterday's Sunday Times, I don't use Whatscrap, etc.


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## Eireog007

mathepac said:


> Yesterday's Sunday Times, I don't use Whatscrap, etc.



Can you provide a link/screenshot of the article in question as I can’t seem to find it online.


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## Purple

Eireog007 said:


> Hey Purple, not sure why you quoted my message there, are you responding to one of my points?


I'm making the point that the health service and government are secondary to the public in terms of who will decide how bad this gets.


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## Eireog007

Purple said:


> I'm making the point that the health service and government are secondary to the public in terms of who will decide how bad this gets.



I didn’t think I’d made a contrary point. I agree that the public have the most say in the severity and duration of the outbreak in this country. Although guidance from the government is a big part of pointing the way.


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## Purple

Eireog007 said:


> I didn’t think I’d made a contrary point. I agree that the public have the most say in the severity and duration of the outbreak in this country. Although guidance from the government is a big part of pointing the way.


Sure, I was just expanding on your post, not disagreeing with you.


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## seamus m

We are only testing 1700 a day 7 to 10 day delays, backlog also in labs. Now 15 per cent positive rates on testing. Our testing is falling way behind


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## llgon

Yes, it is. This is because of resources, mainly the reagent for the lab, for which there is huge demand worldwide, demand up 1000% apparently.  Hopefully it will become more available very soon as the authorities would like to test much higher numbers.

However if those with any symptoms self-isolate for two weeks, it will stop the spread, even if they don't get a test.

Number of confirmed new cases are not increasing as much as they were, however I think this is probably influenced by the restraints of the testing.


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## noproblem

seamus m said:


> We are only testing 1700 a day 7 to 10 day delays, backlog also in labs. Now 15 per cent positive rates on testing. Our testing is falling way behind



That is worrying Seamus and one wonders if behind the scenes there's more than a few things going askew? I find that the info we the ordinary public are being given just doesn't stack up when one does the Math. One of the most worrying of all the data coming out is that almost 25% of the infected are medical staff.


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## RedOnion

noproblem said:


> One of the most worrying of all the data coming out is the almost 25% of the medical staff going down


Do you have a source for a statement like that? Or have I misunderstood your post?


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## Eireog007

RedOnion said:


> Do you have a source for a statement like that? Or have I misunderstood your post?



I'm guessing what was meant by that is that approximately 25% of cases are medical staff not that 25% of medical staff are infected.


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## noproblem

RedOnion said:


> Do you have a source for a statement like that? Or have I misunderstood your post?


Yes, here you go. I should have included it with the post.

The latest available data relates to 2,677 cases reported up until midnight on Sunday.

Of these, there were 118 clusters of infection involving 494 cases.

The median age of those with the virus was 47.

Up until midnight on Sunday, Dr Holohan said there have been 113 admissions to intensive care units.

A quarter of all those with the virus are healthcare workers, accounting for 647 cases.

Dr Holohan said that one quarter of these workers with the virus picked it up via "healthcare-related transmission", while 61% of the infections were acquired in the community.


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## seamus m

noproblem said:


> That is worrying Seamus and one wonders if behind the scenes there's more than a few things going askew? I find that the info we the ordinary public are being given just doesn't stack up when one does the Math. One of the most worrying of all the data coming out is the almost 25% of the medical staff going down


Reading between the lines there has been certainly something askew in nursing homes for sure and I wonder how much of the healthcare workers with covid and deaths are from said homes.I also wonder if the 15per cent rate could be got higher by a visual examination instead of phone consultation even through glass window of homes.This waiting time has to be major issue with track and tracing and clusters.


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## RedOnion

noproblem said:


> A quarter of all those with the virus are healthcare workers, accounting for 647 cases.


Thanks for posting this - you might review your original post because it doesn't say what you intended I think?


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## noproblem

RedOnion said:


> Thanks for posting this - you might review your original post because it doesn't say what you intended I think?


You're correct and have edited my post to reflect that.


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## DeeKie

My sister in law and her partner have the virus. Thankfully neither currently candidates for hospitalisation. He’s pulling out of and has been told he won’t get a test now. She’s 4 days waiting for a test but has been told now she won’t be tested. So they are not in the numbers, will have no contact tracing done and she certainly didn’t take enough precautions (went shopping/jogging etc) while he was waiting his test.


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## Sophrosyne

DeeKie said:


> My sister in law and her partner have the virus.



How do they know they have the coronavirus in the absence of testing?


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## DeeKie

Like many others their GP went through a questionnaire with them on the phone. In each case they show symptoms and the go said he is pretty certain that they both have it.


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## elacsaplau

Hi DeeKie.

I, also, haven't a clue what to make of the numbers.

Remember once it was suggested that circa 40% of the overall population could get it. 

Now, when we test those who really need to be tested, the percentage of these people who have the virus is c. 5% (i.e. 250/5,000)?

I'm also struggling with the "rate of increase in new cases (as a % of total cases) is decreasing" line. Isn't this just math given a fixed number of tests and a relatively consisted number of positives of those tested?


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## Oisin19

The testing, nursing homes and the number of health care workers contracting the virus are not great indicators of how we are doing in our fight against the virus. We will need to improve in these areas sooner rather than later!


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## Oisin19

elacsaplau said:


> Now, when we test those who really need to be tested, the percentage of these people who have the virus is c. 5% (i.e. 250/5,000)?



The scientist confirmed last night that we are only testing 1,500 per day for the last week. We got 324 positive cases yesterday or 21%?  This is too high as I think WHO confirmed that positive results should amount from 3% to 15%. Anything above this means you aren't testing enough. As a result of this it is difficult to ascertain where we are at. We have to get back on top of this really.

For me it has come to the stage that the only figures that matter are the number of deaths and the ICU capacity.


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## Brendan Burgess

elacsaplau said:


> Now, when we test those who really need to be tested, the percentage of these people who have the virus is c. 5% (i.e. 250/5,000)?



Hi elacs

They said yesterday that since the introduction of the new criteria, the positive test figure has increased to 15% from 6%.   

Brendan


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## Brendan Burgess

elacsaplau said:


> I'm also struggling with the "rate of increase in new cases (as a % of total cases) is decreasing" line. Isn't this just math given a fixed number of tests and a relatively consisted number of positives of those tested?



This gives a rough measure of how successful the containment measures are. 

Imagine we had 100,000 infected people and 1,000 new cases per day.   That would be a 1% rate of infection which would probably be less than the rate of recovery. 

If we have 1,000 cases with 500 new cases, it means that it's spreading very fast. 

But if we are testing only 5,000 a day, then the numbers would not be that reliable. 

Presumably we are testing only the most likely suspects? 

Brendan


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## odyssey06

Brendan Burgess said:


> Presumably we are testing only the most likely suspects?



Not exactly -  the focus of the testing is on healthcare workers and those in vulnerable groups or if you have had close contact with a confirmed case.

If you have the symptoms of the virus but are not in those groups, you are not being tested - at least according to the guidelines issued last week.
Given that community transmission accounts for 50% of infections, there's a significant number of likely cases out there not being tested.

Now maybe not all the people with the symptoms actually have the virus, but I expect there is an algorithm out there which will say that's 50% or 80% or whatever of that large group of people. I haven't seen any figures circulated for how many people that is, based on GP phone consultations, even to an approximate %.


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## SPC100

Fergal19 said:


> For me it has come to the stage that the only figures that matter are the number of deaths and the ICU capacity.



I do think number of folks in ICU/spare capacity in ICU is the main indicator to watch, as this is the thing that will directly affects mortality rate.

But again, the problem, is that this number is a trailing indicator, and less useful to make policy decisions on (people only turn up in ICU a week or more after being infected).

Numbers from testing, even if not perfectly representative, are better than no numbers. As it allows us to at model at least some of the likely ICU needs.


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## elacsaplau

Fergal19 said:


> The scientist confirmed last night that we are only testing 1,500 per day for the last week.



What? Is this for real? Seriously?

Three days ago, Anne O'Connor, COO of the HSE, said that we are currently testing 5,000 cases per day. Two weeks ago, Harris said that we needed to ramp up testing to 15,000 per day. Where is the 1,500 coming from and why is the figure so low?


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## seamus m

Brendan Burgess said:


> This gives a rough measure of how successful the containment measures are.
> 
> Imagine we had 100,000 infected people and 1,000 new cases per day.   That would be a 1% rate of infection which would probably be less than the rate of recovery.
> 
> If we have 1,000 cases with 500 new cases, it means that it's spreading very fast.
> 
> But if we are testing only 5,000 a day, then the numbers would not be that reliable.
> 
> Presumably we are testing only the most likely suspects?
> 
> Brendan


How many da


elacsaplau said:


> What? Is this for real? Seriously?
> 
> Three days ago, Anne O'Connor, COO of the HSE, said that we are currently testing 5,000 cases per day. Two weeks ago, Harris said that we needed to ramp up testing to 15,000 per day. Where is the 1,500 coming from and why is the figure so low?


Last night's HSE report live .One of the scientists or doctors said we are testing up to 1700 per day . I don't know where everyone is getting 5000 out of


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## Oisin19

SPC100 said:


> I do think number of folks in ICU/spare capacity in ICU is the main indicator to watch, as this is the thing that will directly affects mortality rate.
> 
> But again, the problem, is that this number is a trailing indicator, and less useful to make policy decisions on (people only turn up in ICU a week or more after being infected).
> 
> Numbers from testing, even if not perfectly representative, are better than no numbers. As it allows us to at model at least some of the likely ICU needs.



The testing is becoming a farce though. Surely they can model off daily demand for ICU beds? As you said people turn up to ICU a week or so after infection so this figure gives a representation of the state of play a week or so previous. As the virus is doubling every 3/4 days they can then project that figure forward to get a current state of play? 

In fairness I'm sure they are probably doing something similar in the background to get a more accurate figure for basis their decisions on. Well I hope so!

What is also becoming more and more frustrating is our so called journalists at the press conferences. If they actually did a bit of "journalism" in advance of the briefings they could ask better questions. You can even see the doctors getting annoyed with them and their questions.


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## Sophrosyne

Latest on the testing figures.

“Dr Cillian De Gascun, chair of the HSE’s Coronavirus Expert Advisory Group, confirmed that 30,213 tests had been carried out but that constraints relating to testing has meant delayed results for some people.

*Dr De Gascun said “significant constraints at a global level” relating to supply issues, including supply of laboratory reagents, has meant prioritising hospitalised patients and healthcare workers for testing for Covid-19. *

“Unfortunately there will be an awful lot of people in the community who will have been waiting maybe seven to 10 days for a result,” said Dr De Gascun.

“That was obviously unanticipated and it is unfortunate but doesn’t really change our plan of ramping up testing over the coming weeks to achieve between 10,000 and 15,000 test per day,” he said.

Last week, health officials decided to change the case definition for Covid-19 tests, narrowing down the focus on particular groups.

Dr De Gascun said this evening that since the case definition changed, the positivity rate had risen from 6% to 15% for those tested in the past seven days. “That’s one of the things we were trying to achieve, by changing the case definition, was to ensure we were testing the right people,” he said.

_Emphasis mine_


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## Leo

seamus m said:


> backlog also in labs.



I only know about one of the labs, but the staff they had rostered to work on Sunday spent the day on their phones as there was nothing outstanding at that point.


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## Brendan Burgess

I don't see the point in collecting the sample if they don't have the lab capacity to analyse it. 

By the time someone 
1) Orders a test 
2) Has the swab taken
3) Gets the results 

They could well be fully recovered. 

In fact , they with a delay between the ordering of the test and taking the swab, they could have recovered. 

Brendan


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## Leo

Brendan Burgess said:


> In fact , they with a delay between the ordering of the test and taking the swab, they could have recovered.



From what I'm hearing, they're very deliberately focusing the priority group, and on ICU demand and those likely to place demands on the system to allow them model and plan the response. So with the tighter criteria around who gets tested, they fully expected the positive test rate to rise significantly. 

Those with milder symptoms who were testing positive were not being admitted to hospital, and were being asked to self-isolate. Well, that's the same advice being given to anyone who thinks they might be ill. So from a system/ resourcing point of view, it makes sense not to test, but you end up relying on people being responsible.


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## Sophrosyne

The intention was and still is to test as many suspected cases as possible.

But like every other country we encountered a supply problem, which caused the change in case definition.

This will be widened as supplies become more available.


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## Eireog007

Sophrosyne said:


> The intention was and still is to test as many suspected cases as possible.
> 
> But like every other country we encountered a supply problem, which caused the change in case definition.
> 
> This will be widened as supplies become more available.



This is exactly it.There are significant shortages of testing kits etc currently at a global level. Therefore the current strategy is to limit the number of those being tested to those showing highly indicative symptoms, those in the high risk categories and medical staff who are in constant contact with those who are contagious.

This consistent panic/bashing about the numbers of tests being performed/% of positive results lack any alternate solutions to the current one.

We are currently at the highest level of lockdown we can realistically maintain over any significant time period which will be interfering with community transmission in the general population and the advice has not changed from day one. If you think you’re sick then you self isolate, if your symptoms are severe enough you will be admitted to hospital and you will appear in the stats. Otherwise as has been said repeatedly the only numbers of any real concern currently are the admissions/ICU total/death rate.

It would be ideal to know all factors, but given the restrictions we are working under this is still the best strategy... in my humble opinion.


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## seamus m

Again I would imagine this lack of testing let it be 2000 a day is one reason our community transmission and clusters are so high .  I mean if our healthcare workers are catching it what chance do primary carers for these cases have when they are not even sure. Also milder cases once nearly over it maybe without even knowing they had it for sure are spreading virus.
Again is phone calls to doctor right method to get testing people know they need 2 symptoms .The thermometers will not lie maybe 2high temp 2 days in row tested on third


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## elacsaplau

seamus m said:


> How many da
> 
> Last night's HSE report live .One of the scientists or doctors said we are testing up to 1700 per day . I don't know where everyone is getting 5000 out of



The figures that I quoted came from various media sources  - as per the following examples:



elacsaplau said:


> Three days ago, Anne O'Connor, COO of the HSE, said that we are currently testing 5,000 cases per day.











						Facts and figures of Coronavirus in Ireland
					

Facts and figures of Coronavirus in Ireland




					www.echolive.ie
				











						Coronavirus: Equipment shortages continue to stall HSE testing schedule
					

Stocks expected to be fully replenished by Tuesday while laboratories also lack reagent




					www.irishtimes.com
				











						15,500 people waiting for coronavirus tests and appointments as HSE scale up
					

15,500 people across the Republic of Ireland are waiting for coronavirus tests. Health chiefs revealed today that they are currently scaling up testing and test centres. ⚠️ Read our coronavirus liv…




					www.thesun.ie
				






elacsaplau said:


> Two weeks ago, Harris said that we needed to ramp up testing to 15,000 per day.











						15,000 tests will be carried out daily in next few days
					

Minister for Health Simon Harris has said it is impossible to predict when 15,000 tests a day will be carried out, but he believes it will happen in the next few days.




					www.rte.ie
				






Eireog007 said:


> This consistent panic/bashing about the numbers of tests being performed/% of positive results lack any alternate solutions to the current one.



As I was central to questioning the numbers, I guess this is, at least in part, directed at me. I understand a little of what you are trying to say. However, my initial point this morning was that the numbers, as presented, didn't add up and it seems pretty clear to me now that this hunch was right.


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## odyssey06

Eireog007 said:


> This is exactly it.There are significant shortages of testing kits etc currently at a global level. Therefore the current strategy is to limit the number of those being tested to those showing highly indicative symptoms, those in the high risk categories and medical staff who are in constant contact with those who are contagious.
> This consistent panic/bashing about the numbers of tests being performed/% of positive results lack any alternate solutions to the current one.



That's not the testing criteria at the moment. You have to be in a priority group.








						Get tested for COVID-19
					

There are 2 types of COVID-19 test available from the HSE- antigen tests and PCR tests.




					www2.hse.ie
				




It's one thing to say, we are focusing our limited test kits on X.
But in some cases, it is not being presented that way. It's being presented as, we are testing enough.
It's also not panic \ bashing to say that we need to be testing more, we need more test kits while accepting right now we have to limit the tests.


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## Eireog007

elacsaplau said:


> I was central to questioning the numbers, I guess this is, at least in part, directed at me. I understand a little of what you are trying to say. However, my initial point this morning was that the numbers, as presented, didn't add up and it seems pretty clear to me now that this hunch was right.
> [/URL]


http://
It wasn’t intended as a shot at anybody in particular really just a general undercurrent of that sentiment I’ve noticed a lot recently.

I will admit I hadn’t seen the change in protocol to restrict it to those priority groups but I do understand the reasoning behind it. If we have limited resources then we must focus them where they will do the most good.

Also our capability to test 5000 per day and the restricted criteria leading to us only requiring 1500 per day do not mean both are not the truth.


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## Eireog007

odyssey06 said:


> That's not the testing criteria at the moment. You have to be in a priority group.
> 
> 
> 
> 
> 
> 
> 
> 
> Get tested for COVID-19
> 
> 
> There are 2 types of COVID-19 test available from the HSE- antigen tests and PCR tests.
> 
> 
> 
> 
> www2.hse.ie
> 
> 
> 
> 
> 
> It's one thing to say, we are focusing our limited test kits on X.
> But in some cases, it is not being presented that way. It's being presented as, we are testing enough.
> It's also not panic \ bashing to say that we need to be testing more, we need more test kits while accepting right now we have to limit the tests.



I did miss the change to only test within those priority groups so apologies for that part.

Testing enough and not testing our maximum capability are not mutually exclusive though.


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## Leo

seamus m said:


> Again I would imagine this lack of testing let it be 2000 a day is one reason our community transmission and clusters are so high .  I mean if our healthcare workers are catching it what chance do primary carers for these cases have when they are not even sure. Also milder cases once nearly over it maybe without even knowing they had it for sure are spreading virus.



Nothing new there, it's been well established that asymptomatic transmission is a feature of COVID-19, as are high false-negative test results the among pre-symptomatic population. STaff in care homes are included in the priority group, so will be tested as appropriate.



seamus m said:


> The thermometers will not lie maybe 2high temp 2 days in row tested on third



There are lots of reasons people run a temperature. High temperature alone still won't get you a test even if you're working in ICU.


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## seamus m

Leo said:


> Nothing new there, it's been well established that asymptomatic transmission is a feature of COVID-19, as are high false-negative test results the among pre-symptomatic population. STaff in care homes are included in the priority group, so will be tested as appropriate.
> 
> 
> 
> There are lots of reasons people run a temperature. High temperature alone still won't get you a test even if you're working in ICU.


The point had nothing to do with asymptomatic or pre symptomatic just the simple fact that virsus will be passed due to lack of testing and knowledge whether you have or had virus or not.
The second point had also to do with fact paper dosnt refuse ink and also a visit from doctor or healthcare worker to test  symptoms instead of a call would probably bring strike rate higher when we obviously haven't ability to test more .


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## Leo

seamus m said:


> The point had nothing to do with asymptomatic or pre symptomatic just the simple fact that virsus will be passed due to lack of testing and knowledge whether you have or had virus or not.



No, it'll be passed if people don't respect the distancing or isolation advice. Lots of people will be contagious but will test negative.



seamus m said:


> a visit from doctor or healthcare worker to test  symptoms instead of a call would probably bring strike rate higher when we obviously haven't ability to test more .



The main thing that would achieve is to consume more test kits and PPE and waste the time of staff.


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## Brendan Burgess

Leo said:


> Lots of people will be contagious but will test negative.



I don't understand that?


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## john luc

with some confirmed as having the virus we see some as  old and others serious so is their variants of the virus.


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## noproblem

Regardless of the optimism from some quarters in the HSE,  when the backlog of results start to come back from the tested patients with the new criteria I can only see a huge increase in infections and ICU admissions. This will be very unsettling for older people but the same few will still ignore everything. Even in the countryside I'm seeing the over 70's +, out walking, shopping and chatting. In a lot of ways I've sympathy for them as their mindset seems to be, they'll die if they stay inside anyway, so?


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## Brendan Burgess

noproblem said:


> when the backlog of results start to come back from the tested patients with the new criteria I can only see a huge increase in infections and ICU admissions.



I doubt that the ICU admissions are related to testing in any way. 

People are admitted to ICU when they are very sick. Quite a few of them have not been tested yet. 

Brendan


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## odyssey06

Brendan Burgess said:


> I doubt that the ICU admissions are related to testing in any way.
> People are admitted to ICU when they are very sick. Quite a few of them have not been tested yet.
> Brendan



Its the opposite flow. The first community transmission identified was an untested patient who presented at a&e with severe respiratory condition and I think died subsequently.

They werent processed as a coronavirus case as they hadnt travelled or had identified contact with a confirmed case.

Led to infections in the medical staff that treated the patient. 

Only testing cases of v limited criteria has risks.


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## Eireog007

Interesting point just clarified on tv that we are carrying out thousands of swabs per day at the new sites around the country but it’s the labs which are currently limited to around the 1700 tests of those swabs per day. I think that might be leading to some confusion in reporting of testing numbers as they aren’t distinguishing between those two stages clearly enough.

Also quite interesting is that we are bringing on board a veterinary lab which is used for testing every calf in the country and performed 1.5 million tests last year and will be running 24/7 shifts. Provided we can get our hands on adequate supplies of reagents then testing should increase massively over the next weeks.


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## Fidgety

Eireog007 said:


> Also quite interesting is that we are bringing on board a veterinary lab



In Germany, veterinary labs were used early to process tests and they can now handle 100,000 tests per day. I don't know how long it takes to turnaround the test results.


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## Eireog007

Fidgety said:


> In Germany, veterinary labs were used early to process tests and they can now handle 100,000 tests per day. I don't know how long it takes to turnaround the test results.



The current test turnaround time once it starts in the lab is around 5 hours. I think it took a bit of time to convert their test set up to be compatible.


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## Fidgety

In New York, 80% of patients in ICU requiring ventilators never recover according to Governor Cuomo. That's a frightening prospect.


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## losttheplot

This is from an article in The Guardian, fits in with the experience of Italian doctors treating younger patients over older ones. Not a decision I'd like to make.









						Coronavirus: new figures on intensive care deaths revealed
					

Findings of new report raise concerns about how effective new facilities will be




					www.theguardian.com
				




"The truth is that quite a lot of these individuals [in critical care] are going to die anyway and there is a fear that we are just ventilating them for the sake of it, for the sake of doing something for them, even though it won’t be effective. That’s a worry,” one doctor said."

 It was based on numbers early on. Males more at risk and weight also s possible factor.


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## Leo

Brendan Burgess said:


> I don't understand that?



The tests are not 100% accurate. Some of the studies from China are show tests returning 30% and higher rates of false negatives. The new faster test kits being deployed are believed to bring false negative rates down to ~15%, but not enough data exists yet to verify that. These patients will still be contagious, and the risk is they take assurance from the negative result and circulate more.


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## SPC100

Overall stats are something like 20 percent of cases hospitalised, 5p.c. need ICU, 1-2p.c.fatal.

So 20 to 50 p.c. of folks in icu likely will pass away.

But that rate depends on the risk factors of the population who are in ICU. Older, other illness etc all drive the fatality rate higher, as does ICU being out of capacity.

If median infected age is 83, the rate of recovery in ICU will be lower vs if median was 40.


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## odyssey06

It would also be interesting to see the spread of cases for hospitals, nursing homes versus general population community transmission in light of the below.

Almost 100 staff members and residents in one nursing home have tested positive for coronavirus, the Dáil has heard today. 
Fianna Fáil’s spokesman for health Stephen Donnelly said the nursing home has 200 staff, 70 of whom have tested positive for Covid-19.
He said of the 100 residents, 19 have tested positive and four have died.








						Almost 100 staff and residents in one nursing home test positive for Covid-19, Dáil hears
					

Fianna Fáil’s Stephen Donnelly raised the matter in the Dáil today.




					www.thejournal.ie


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## Firefly

Leo said:


> The tests are not 100% accurate. Some of the studies from China are show tests returning 30% and higher rates of false negatives. The new faster test kits being deployed are believed to bring false negative rates down to ~15%, but not enough data exists yet to verify that. These patients will still be contagious, and the risk is they take assurance from the negative result and circulate more.


Also, someone could "pick up" the virus by, say, touching a door handle and even though they might not get the virus themselves could pass it on...


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## Leo

Firefly said:


> Also, someone could "pick up" the virus by, say, touching a door handle and even though they might not get the virus themselves could pass it on...



Yep, surface contact isn't suspected to be a major source of contagion, but someone touching a contaminated surface will spread it to other surfaces for a time.


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