Coronavirus: Trial urges people to call 111 before going to A&E (England)

[Northerner]

People requiring A&E will be urged to book an appointment through NHS 111 under a trial in parts of England.

The aim is to direct patients to the most clinically-appropriate service and to help reduce pressure on emergency departments as staff battle winter pressures, such as coronavirus and flu.

The pilots are live in Cornwall, Portsmouth, Hampshire and Blackpool and have just begun in Warrington.

If they are successful, they could be rolled out to all trusts in December.

However, people with a life-threatening condition should still call 999.

Coronavirus: Trial urges people to call 111 before going to A&E

The pilots aim to help hospitals cope with winter pressures, including coronavirus and flu.

www.bbc.co.uk

Whilst there is logic to this in current circumstances my prediction is that the next big problem is going to be people being unable to get through on 111

 

[Bruce Stephens]

Whilst there is logic to this in current circumstances my prediction is that the next big problem is going to be people being unable to get through on 111

Or being advised to visit A&E hundreds of miles away.

 

[Amity Island]

Here comes the 2nd wave of excess deaths, caused by more lockdown related policies.

All based around a test that:

Doesn't tell you if someone is actually infectious.
Doesn't tell you if someone is actually sick.
Doesn't tell you if someone has a current infection or a past one.

 

[everydayupsanddowns]

Here comes the 2nd wave of excess deaths, caused by more lockdown related policies.

All based around a test that:

Doesn't tell you if someone is actually infectious.
Doesn't tell you if someone is actually sick.
Doesn't tell you if someone has a current infection or a past one.

If that‘s the case then I guess my questions would be:

Is there a better test?
Is that test viable and scalable?
Is that test affordable?

And if the answer to those questions is no, then it seems to me the current test should be used until there is.

It’s not perfect, but it has value. It means people who test negative can carry on rather than everyone having to stop all the time. It also gives a clue, or a hint, or an idea of where there are increasing ‘hotspots’.

When I have been on flights recently, I have taken my boots off as part of the security ‘test’. I know for a fact that there are no explosives in my boots, but I accept that taking my boots off is part of keeping everyone safe, because there was someone ONCE who had a bomb in their boots. If it looked like there was a bomb in my boots on the xray and I was dragged into a side room as a result of a false positive... I know that on further inspection it would become clear that there was no bomb, and I would be free to catch the flight.

I also know that it is extremely unlikely that anyone else has a bomb in their boots on any flight I take. But the risk exists that someone *might* have... so we all dutifully take our boots off even though we all know individually that we don’t need to. Because the other ’test’ of “Excuse me sir do you have a bomb in your boots” carries a high risk of a false negative exactly when it matters most, and cannot be used.

So there is precedent for using tests that carry a burden of individual inconvenience for the greater good, and a reduction in potential risk. Even if that risk can be argued to be very low or even non-existent in many cases.

 

[Lanny]

@everydayupsanddowns WHAT a way of putting things! Made me laugh yet, your point is clear!🙄

 

[mikeydt1]

111 couldn't organise a pee up in a brewery. front staff just run on scripts and if you don't fit then they haven't a clue what to do.

first it takes ages to get through then you are passed from front staff to a nurse then and only then if you are lucky and i stress lucky you might be offered help either speak to a doctor who hasn't a clue, ambulance or told to wait 11 hours or so till your doctors open, by then you are so ill that an ambulance is needed any way 😡 or you simply drop dead!

 

[Amity Island]

If that‘s the case then I guess my questions would be:

Is there a better test?
Is that test viable and scalable?
Is that test affordable?

And if the answer to those questions is no, then it seems to me the current test should be used until there is.

It’s not perfect, but it has value. It means people who test negative can carry on rather than everyone having to stop all the time. It also gives a clue, or a hint, or an idea of where there are increasing ‘hotspots’.

When I have been on flights recently, I have taken my boots off as part of the security ‘test’. I know for a fact that there are no explosives in my boots, but I accept that taking my boots off is part of keeping everyone safe, because there was someone ONCE who had a bomb in their boots. If it looked like there was a bomb in my boots on the xray and I was dragged into a side room as a result of a false positive... I know that on further inspection it would become clear that there was no bomb, and I would be free to catch the flight.

I also know that it is extremely unlikely that anyone else has a bomb in their boots on any flight I take. But the risk exists that someone *might* have... so we all dutifully take our boots off even though we all know individually that we don’t need to. Because the other ’test’ of “Excuse me sir do you have a bomb in your boots” carries a high risk of a false negative exactly when it matters most, and cannot be used.

So there is precedent for using tests that carry a burden of individual inconvenience for the greater good, and a reduction in potential risk. Even if that risk can be argued to be very low or even non-existent in many cases.

Or you could of just as easily said, you are quite right about the tests.

 

[everydayupsanddowns]

Or you could of just as easily said, you are quite right about the tests.

Oddly I thought we were saying quite different things!

I thought you were saying (both here and in other posts about false positive/negative) that the tests were no good and that they shouldn’t be used?

Which isn’t what I think at all!

Do you think the current tests are worthwhile and should be used? I am confused now

 

[Amity Island]

Oddly I thought we were saying quite different things!

I thought you were saying (both here and in other posts about false positive/negative) that the tests were no good and that they shouldn’t be used?

Which isn’t what I think at all!

Do you think the current tests are worthwhile and should be used? I am confused now

You're funny Mike! You've got my point now LOL. I feel bad cos you'd put such a lot of effort into your reply. lol
I hadn't said anything about false positives or false negatives. Just that we could do with more than just a positive test, if we are going to lock down whole towns and cities, surely, we need to know if people are actualy infectious before making those kind of moves?? The tests are definitely useful, but limited.

 

[everydayupsanddowns]

I hadn't said anything about false positives or false negatives

I haven‘t watched it yet... but I viewed this post before I replied

False Positives PCR Test

Back by popular demand today Dr Mike Yeadon on false positives.

forum.diabetes.org.uk

On forums you tend to get a feel for what you think people think because of things they choose to share, and comments they make on other threads over time I find.

Sorry if I’ve got the wrong end of the stick about what you think.

 

[Amity Island]

I haven‘t watched it yet... but I viewed this post before I replied

False Positives PCR Test

Back by popular demand today Dr Mike Yeadon on false positives.

forum.diabetes.org.uk

On forums you tend to get a feel for what you think people think because of things they choose to share, and comments they make on other threads over time I find.

Sorry if I’ve got the wrong end of the stick about what you think.

Hi Mike, I try to post things worthy of posting. Like the other post I made the other day about false positives. It doesn't mean I think the tests aren't useful or worth doing, just that the tests do give out false positives and they also give out false negatives. I just think it's important that people get the whole story, the complete picture.

 

[everydayupsanddowns]

I think the things you post point to a viewpoint about the worthiness of covid testing and appropriateness of the lockdown measures - it may be unintentional - but they do give an impression.

Perhaps it isn‘t what you think though?

 

[Amity Island]

I think the things you post point to a viewpoint about the worthiness of covid testing and appropriateness of the lockdown measures - it may be unintentional - but they do give an impression.

Perhaps it isn‘t what you think though?

Hi Mike,
You're right, I don't hold the view that tests aren't worth doing, only the view that they are limited. I do however think that the late lockdown was the wrong strategy, that's only my opinion and everyone is entitled to one, even if others don't agree.

 

[Docb]

If I can join in... I used to do a lot of work in quality control and the point you make, @Amity Island is quite sound. Anybody who has worked in the field knows full well that all testing has some error and you need to adjust the test protocol depending on whether you prefer to bias your test results to minimise or eliminate either false positives or false negatives. In those cases where you want to eliminate both then you finish up with extremely long, complicated and expensive protocols.

When it comes to normal things, like covid testing, there will be both false positives and false negatives and somebody somewhere has to make a judgement about what levels of false negatives or false positives are acceptable. Whatever they come up with somebody somewhere is going to disagree with them.

It's another area where people bandy numbers about and ought to say up front...

**WARNING ** This is one way of looking at the data... other ways of looking at it are available.

Much sympathy with your view on COVID strategy but my biggest annoyance is that those promulgating the strategy treated it as a PR exercise. I personally would have preferred an approach which showed various strategies had been looked at, what they were, what the pros and cons of each were, and which was decided on. Treat the populace as adult and not a bunch of punters who have to be persuaded to buy whatever it is you have to sell is what I say.

 

[Amity Island]

If I can join in... I used to do a lot of work in quality control and the point you make, @Amity Island is quite sound. Anybody who has worked in the field knows full well that all testing has some error and you need to adjust the test protocol depending on whether you prefer to bias your test results to minimise or eliminate either false positives or false negatives. In those cases where you want to eliminate both then you finish up with extremely long, complicated and expensive protocols.

When it comes to normal things, like covid testing, there will be both false positives and false negatives and somebody somewhere has to make a judgement about what levels of false negatives or false positives are acceptable. Whatever they come up with somebody somewhere is going to disagree with them.

It's another area where people bandy numbers about and ought to say up front...

**WARNING ** This is one way of looking at the data... other ways of looking at it are available.

Much sympathy with your view on COVID strategy but my biggest annoyance is that those promulgating the strategy treated it as a PR exercise. I personally would have preferred an approach which showed various strategies had been looked at, what they were, what the pros and cons of each were, and which was decided on. Treat the populace as adult and not a bunch of punters who have to be persuaded to buy whatever it is you have to sell is what I say.

Hi DocB,

Thanks very much for your reply, I appreciate it.

It's really nice to hear some balanced feedback from my posts and comments. Some are drawing the conclusion that I am against the tests, or that I think they are a waste of time, I'm not. I'm only trying to put across a fuller picture and a more accurate one.

 

[Docb]

No problem @Amity Island. You need to get involved in the QA and QC of fuel put into nuclear reactors. There the need to get an accurate view of how good the testing is tends to concentrate the mind on some of these issues. There is a lot more to it than some would have you believe.