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Almost third of UK Covid hospital patients readmitted within four months

theguardian.com

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Re: Almost third of UK Covid hospital patients readmitted within four months

#191

Post by systemvoltage »

martyvis wrote: post #189
systemvoltage wrote: post #138

Earlier quoted context omitted.

USA is 330 million people. New Zealand is 1/2 the population of SF Bay Area. Just because NZ can demonstrate good COVID control, it cannot just apply at a massive nation. China has done it with authoritarian enforcement. There is no solution to this for USA, EU or large countries. Asian nations such as Japan and Korea are culturally different than the west. It’s impossible to change the culture of 330 million overnig…

> it cannot just apply at a massive nation And yet the massive USA clearly showed through COVID control that it is simply a collective of hundreds of fiefdoms (states, cities and even corporations) they for the most part were uncoordinated and did what was best for themselves, which turned out to be no good for no one.

That's a feature not a bug IMO. I'd like individual counties and states control their fate, not federal gov since enforcement and containment is extremely localized. Federal gov can help with shortage of beds, food supplies and vaccine development which they did through Operation Warpspeed. It is befitting for Fed and illfitted to local counties.

Here in Bay Area, there was much stricter control. Counties choose their fate, their path and their citizens want to trade off lockdowns vs. COVID rates. It's their call and I respect that kind of governance.

At the extreme - I would absolutely abhor China style lockdowns in the USA.

Did the USA fared well with COVID response? Not at all. Federal gov could have done a lot better to provide guidance (not enforcement) to states and counties.

Re: Almost third of UK Covid hospital patients readmitted within four months

#192

Post by SturgeonsLaw »

noodlenotes wrote: post #166
surfpel wrote: post #3

Link to the study: https://www.bmj.com/content/372/bmj.n693 From the study: > At baseline, individuals with covid-19 had a mean age of 64.5 (standard deviation 19.2) and 54.9% were men. Compared with the general population, individuals in hospital with covid-19 were more likely to be: male, aged 50 or more, living in a deprived area, a former smoker, and overweight or obese (table 1). Individuals with covid-19 were a…

I remember at the beginning of the pandemic, it seemed as though few current smokers were getting seriously ill, although former smokers were at high risk. Did anything come of that?

That has been observed, and nicotine proposed as a potential therapeutic aid. The mechanism could be because the SARS-CoV-2 spike protein binds to the same nicotinic acetylcholine receptors that nicotine binds to.

> A total of 5960 patients were included in the studies identified. The current smoking prevalence ranged from 1.4% (95% CI 0.0–3.4%) to 12.6% (95% CI 10.6–14.6%). An unusually low prevalence of current smoking was observed from the pooled analysis (6.5%, 95% CI 4.9–8.2%) as compared to population smoking prevalence in China. The secondary analysis, classifying former smokers as current smokers, found a pooled estimate of 7.3% (95% CI 5.7–8.9%). In conclusion, an unexpectedly low prevalence of current smoking was observed among patients with COVID-19 in China, which was approximately 1/4th the population smoking prevalence. Although the generalized advice to quit smoking as a measure to reduce health risk remains valid, the findings, together with the well-established immunomodulatory effects of nicotine, suggest that pharmaceutical nicotine should be considered as a potential treatment option in COVID-19.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210099/

> Based on the early observations of the lower than expected smoking prevalence in hospitalised COVID-19 patients, Changeux and colleagues suggested a role for nicotinic acetylcholine receptors (nAChRs) in the pathophysiology of COVID-19 via a direct interaction between these receptors and the viral spike (S) glycoprotein.11 This suggestion was based in the fact that the S protein from SARS-CoV-2 contains a sequence motif similar to known nAChR antagonists11 (Figure S1), such as α-bungarotoxin from Bungarus multicinctus and glycoprotein from Rabies lyssavirus (formerly Rabies virus). Changeux et al. also proposed that COVID-19 might be controlled or mitigated by the use of nicotine, if the latter can sterically or allosterically compete with the virus for binding to these receptors.9,11

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386492/

Re: Almost third of UK Covid hospital patients readmitted within four months

#193

Post by g8oz »

bedhead wrote: post #8

There is a ton of selection bias here, these are already generally speaking very unhealthy people.

But plenty of people who are similarly unhealthy (obese, smokers etc.) live for years with those problems..Covid seems to be pushing them over the edge.

Maybe a better question to ask would have been: typically do 1 in eight people who have been discharged from the hospital after non-covid issues and have the same co-morbidities as the group in the study die within 4 months?

Re: Almost third of UK Covid hospital patients readmitted within four months

#194

Post by stretchwithme »

sithadmin wrote: post #122
stretchwithme wrote: post #92

Earlier quoted context omitted.

I had persistent lung congestion for weeks. I did some research online and found this thing called a salt inhaler. That cleared it up in a couple of days. Salt has a way of pulling infections out of tissues.

I'm not a physician, but intentionally inhaling salt particles into the respiratory tract to 'pull infections out of tissues' strikes me as an extremely bad idea.

The American Lung Association has this article on the topic. And there is no consensus about how much is effective, etc.

'"When fine salt particles are inhaled, they will fall on the airway linings and draw water into the airway, thinning the mucus and making it easier to raise, thus making people feel better," said Dr. Edelman.'

https://www.lung.org/blog/promising-placebo-salt-halotherapy...

There is salt in the air at the beach, so I'd stay away from the ocean if you think inhaling salt is a bad idea.

Re: Almost third of UK Covid hospital patients readmitted within four months

#195

Post by trickstra »

ahepp wrote: post #95
trickstra wrote: post #86

Earlier quoted context omitted.

Hello from Vietnam. Lockdowns are not about islands. It helps, kinda, but not completely. Vietnam completely sacrificed the tourist industry, unlike US or Europe. Quarantine is at a designated facility, not at home, unchecked, like in US or Europe. And dissent is suppressed. The last part is a bit unfortunate, but the former ones are really just a matter of decision. And it works.

Sincere congratulations, living in the US I think it's inspiring to see all the countries with incredible (and relatively equally distributed) health outcomes at costs that society can bear. That said, I want people from island countries to stop saying "being an island country has nothing to do with it", when all evidence and logic says being an island country has a lot to do with it. I'll happily take criticism from…

Yes, overwhelming majority can easily be wrong. That's not surprising.

And islands still have to watch for random boats from any direction. Right now in Vietnam there is a little outbreak where a group of Vietnamese nationals illegally crossed the border by a fishing boat from Cambodia to Phu Quoc island, trying to avoid the mandatory two-week quarantine. Then they boarded a plane, arrived at their homeland and tested positive. Immediately their steps were traced by police, whole Phu Quoc is under a mask mandate, 3 levels of contacts are tested and in quarantine. It really isn't about being an island. That's a myth, you've been lied to. If you want an example closer to your home, look how hard it is to seal a land border with Mexico. They actually cross by rivers, so water makes it easier.

Re: Almost third of UK Covid hospital patients readmitted within four months

#196

Post by azakai »

peytn wrote: post #175
azakai wrote: post #153

Earlier quoted context omitted.

See the discussion above - it's very intentional that the control group wasn't hospitalized. It's the right approach for the question they are trying to answer, "how bad off is a person that got COVID and got hospitalized as a result of that". (There are other good questions to ask too, of course.)

Given the discussion generated here and probably elsewhere, why do you believe the authors chose not to present a matched hospitalization control group alongside their control group? It’s pretty standard: that’s why they included a sentence saying they chose not to (albeit without any justification). Why deviate?

As mentioned in the discussion above, their control group answers the question "if a person got COVID and was hospitalized because of it, how much worse off are they than had those things not happened?"

They do justify their choice in the actual paper (e.g. see the end of the "Study population" section).

(It's also interesting to compare COVID hospitalizations to other ones, say from a heart attack or allergic reaction, but those are different questions. For example, maybe a COVID hospitalization is less bad than one due to a heart attack, or worse than an allergy. Or maybe any hospital visit is just bad period. But given many people got hospitalized by COVID this year - something that never happened in the past - we need to know what that event cost them, that's the point of this study.)

Re: Almost third of UK Covid hospital patients readmitted within four months

#197

Post by amluto »

Izkata wrote: post #183
amluto wrote: post #103

Earlier quoted context omitted.

They periodically reimport it. If I had to guess, I would guess that COVID can be transmitted by fomites, especially if kept cold, but that it’s extremely rare. In a place like the US or Europe, this is insignificant: your chance of getting seriously sick due to touching something is negligible, and the rate of additional cases due to this effect is inconsequential for public health. But in AU or NZ, where the backgr…

> They periodically reimport it. Right, so why would the US - with much more porous borders - somehow do better?

I think doing as well as NZ would be a laudable goal. If the whole world did that well, then I think COVID would be quickly eradicated.

But, beyond the fact that the US has large land borders, the US has a genuine problem. We are economically dependent on legal and illegal cross-border seasonal migration. I personally think that, with actual political will, the borders could be made a lot less porous, but this would involve attacking the supply and demand sides. Neither party is interested.

Re: Almost third of UK Covid hospital patients readmitted within four months

#198

Post by redis_mlc »

timr wrote: post #179
nostrademons wrote: post #156

Earlier quoted context omitted.

Similarly, I've been wearing my seatbelt my whole life and have never gotten into an accident while driving. My kid was placed on his back in the crib without any pillows or blankets, even though he hated it, but never once stopped breathing. I have health insurance but ... shit, there was that one time in high school where a kidney infection put me in the hospital and would've killed me had I not gone, was billed at…

> There's a reason we pay attention to tail risks, where the low-probability negative consequences are far worse than the high-probability costs of averting them. The vast majority of people are not going to die in car crashes, or of SIDS, or of COVID, or from untreated kidney infections. They are lucky. No, by definition , they're the norm. They're not lucky , they're just normal. The expected outcome. The people wh…

> I would also discourage anyone else from reading HN posts with obscure technical documents from Boeing and the FAA, and speculating about what it means for aviation in general.

Well, speak for yourself. I'm a commercially-rated pilotwho does maintenance test flights, and I study aerodynamics, so I can and do interpret obscure documents - in fact, it's my responsibility to know how airplane systems work.

The significance of the Denver accident is:

1) it's not being called an uncontained engine explosion, yet there's parts everywhere

2) the engine accessories kept burning after the fuel was shutoff. Apparently the engine fire suppression equipment doesn't work without the engine shroud - that sounds like a problem, especially since fuel is usually stored in wings.

Re: Almost third of UK Covid hospital patients readmitted within four months

#199

Post by peytn »

azakai wrote: post #196
peytn wrote: post #175

Earlier quoted context omitted.

Given the discussion generated here and probably elsewhere, why do you believe the authors chose not to present a matched hospitalization control group alongside their control group? It’s pretty standard: that’s why they included a sentence saying they chose not to (albeit without any justification). Why deviate?

As mentioned in the discussion above, their control group answers the question "if a person got COVID and was hospitalized because of it, how much worse off are they than had those things not happened?" They do justify their choice in the actual paper (e.g. see the end of the "Study population" section). (It's also interesting to compare COVID hospitalizations to other ones, say from a heart attack or allergic reacti…

I read the paper. That is not a justification. If you are unwilling to entertain the idea that this is a low-quality report, go ahead. I can only contribute some prior experience on an Internet forum in an attempt to shed light on a politically fraught result from what appears to be a government scientist and some collaborators.

Re: Almost third of UK Covid hospital patients readmitted within four months

#200

Post by mattmanser »

timr wrote: post #114
mattmanser wrote: post #109

Earlier quoted context omitted.

Ok, but the UK has a large, integrated, health care system, with an office of national statistics that is following the disease and published this data. It also talks about how poorer people, and those from non-white backgrounds are disproportionately likely to have worse outcomes. Just because you don't see it happening in your circles, doesn't mean it's not happening in other ones. The authors write in the BMJ: “Th…

> Ok, but the UK has a large, integrated, health care system, with an office of national statistics that is following the disease and published this data. Having an office of national statistics does not mean that this particular paper is being reported correctly by the mass media, it doesn't mean that the paper itself supports the discussion of "long covid" amongst otherwise healthy people, and it certainly doesn't…

You can go read their report yourself if you want and see that what you've claimed is factually incorrect. Plus, all the data is there, in CSV or XLS format if you want to check their maths:

https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

To me, they seem to be trying to make it as accessible and clear as possible with most news articles taking the salient points directly from the ONS's own summary.

As you can see from figure 2, their data is not focused on old people as you erroneously claim, it does seem to show that more deprived = more symptoms, and that non-white are more likely to have symptoms.

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