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Old 01.03.2020, 11:20
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Re: Coronavirus

I'm so grateful schools are still open. Teachers have been receiving instructions from their canton on how to be proactive (hygiene procedures) and reactive (recommend immediate GP consultation when they suspect Coronavirus symptoms).

It has also been recommended to avoid traveling to North Italy for the time being.

As if teaching isn't hard enough....
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  #1282  
Old 01.03.2020, 11:53
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Re: Coronavirus

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Is Switzerland doing any proactive testing or are they waiting for people to self report with symptoms?
In case you or anyone else missed it, this was the advice given by Danial Koch in yesterday's press meeting...(Sorry for the long post, but for the sake of clarity...)
If you want to translate the rest of the meeting or watch it for yourself, it's here...
https://www.20min.ch/schweiz/bern/st...-Lage-29257822


"Don't turn your life upside down"
The Confederation appeals to the population: younger people with a cold should not run for the emergency. Otherwise the corona tests could become scarce.

The Swiss authorities are not planning any new massive measures such as border or school closures in connection with the coronavirus, at least not for the next few days. The next step will be a further information offensive at the beginning of next week.

This will involve written recommendations to the population as to what more they can do to protect themselves as far as possible against infection or transmission of the Covid-19 virus, as Daniel Koch, Head of Communicable Diseases at the Federal Office of Public Health (FOPH), told the media on Saturday.

He also said that the population should remain calm over the weekend and not turn their entire way of life upside down. He said that the aim was to conserve resources and not to overburden hospital emergencies with minor cases.

Border closures are not an option at the moment, because they would not help and would also prevent many border crossers from working in hospitals and medical practices, Koch said. He also said that it did not make sense to close schools at the moment, as it has been proven that it is mainly people over 60 who are most at risk. Children are not the main carriers of the virus.

Situation in Italy "alarming

However, the situation in Italy is "worrying", given the 885 confirmed cases and 21 deaths to date, a large number of unreported cases must be assumed. For Switzerland, this means that it is on the verge of the situation getting "out of control" and that the pathways of infection can no longer be traced in every case.

"We will not be able to completely test and isolate every case that coughs over a long period of time," said Koch. In future, the focus will have to be on the severe cases. A great deal of self-discipline and self-responsibility is therefore required of the mild cases.

It is also important not to push the laboratory staff to the limit "before we need to". The products for the laboratory tests are slowly becoming scarce and should not be "burned up" with light cases.

In Switzerland, however, the number of confirmed cases is currently unchanged at 13. According to Koch, all of them were infected in Italy. There are indications that the 5 suspected cases still open could have been indirectly infected.

All of these people were infected at least a week ago. However, there are certainly other carriers of the virus in Switzerland who either pass on the disease without showing symptoms or who become ill themselves. As soon as the infection is confirmed in Switzerland, the suspicion criteria would have to be expanded, Koch said.

Mild course in most cases

Koch emphasized several times that the disease takes a mild course in the vast majority of cases. The infection is much more dangerous for the elderly population, where the virus circulates mainly. For this reason, it is not a good idea for families to appoint grandparents to look after children, so that parents can continue working if they have sick children at home.

Koch further specified that the ban on events with more than 1000 people does not mean that events with 999 people or less are generally permissible. In any case, the organisers are obliged to weigh up the risks, with the involvement of the respective cantons. On Monday at the latest, a comparison will be made between the cantons.

On 29 February, four further suspicious cases were definitively confirmed in the canton of Graubünden. A total of six people in the canton are now positive, 27 are still being investigated. Picture: Daniel Karmann

On 28 February, Daniel Koch, Head of the Communicable Diseases Division at the Federal Office of Public Health FOPH, announced that there were 13 confirmed cases in Switzerland. Picture: Keystone/Alessandro Della Valle

Case 9: The canton of Vaud reports that it has its first coronavirus patient. This is a 49-year-old man.

No further repatriations from abroad are necessary at the moment, as Hans-Peter Lenz, head of the crisis management centre in the FDFA's Foreign Department, explained. Travellers would decide at their own discretion and would not be entitled to an organized departure from a crisis area. However, Swiss representations would offer assistance, advice and support.

Eric Scheidegger, Head of the Economic Policy Directorate in the State Secretariat for Economic Affairs (Seco), reminded the audience of the possibility that companies could now also be forced to leave the country due to the effects of the Corona

Situation abroad

"We draw attention to the fact that Swiss nationals have no right to leave a crisis area." However, the FDFA is available as a point of contact.

Now Hans-Peter Lenz from the Federal Department of Foreign Affairs says: "At present, no persons in other countries have to be returned to Switzerland.
Schools

Closing schools is also out of the question at present: "Children are not at risk. Even if they fall ill, their illness is usually mild. The first priority is to protect the grandparents: "If we close the school now, the children will be looked after by the grandparents. It would be dangerous for the older generation."

Koch: "There are no new, heavy measures planned at the moment." A border closure is not an option at this time. "Also because we are dependent on medical personnel crossing the border."

For people who have severe respiratory problems, or the elderly, this does not apply to this extent.
Appeal to the population

It is important to know: "We must save our resources. We'll have to concentrate on the more difficult cases." Minor cases, people who have a slight cold or fever are asked to stay home. "Such people shouldn't all rush to hospital. We cannot now overload our hospital staff and doctors over the weekend," said Koch.

The FOPH expects that there will be further infections. "The cases that we are currently recording were infected last week," said Koch.

Koch emphasizes: "For most people, especially for young people, the disease is rather harmless. It is only dangerous for older people."

"In the vast majority of cases the disease is mild. The disease is dangerous for the elderly population, where it also grazes the most", says Koch. This is also the case in China. Even children are practically not affected there.

In Italy, 885 confirmed cases were known and 21 of the infected persons had died. This is very worrying because of the apparently large number of unreported cases.
17 cases

Koch: "We currently have twelve confirmed corona cases in Switzerland. In five other cases a first positive test has been obtained, but here the result of the reference test is still pending".

The FOPH is the first to do so. Daniel Koch: "Unfortunately, events evolve very quickly." Yesterday's Federal Council decree to ban events involving more than 1000 people has caused a lot of discussion. "Events under 1000 are either approved or not by the cantons."

At today's press conference, three departments will provide information on the current status of the coronavirus. Present are Eric Scheidegger, Head of the Economic Policy Directorate at Seco, Hans-Peter Lenz from the FDFA's Crisis Management Centre and Daniel Koch, head of the FOPH's department.
New information for the public

After banning major events throughout Switzerland on Friday because of the coronavirus, the Federal Council wants to continue informing the population today at 13.30 hrs. The media conference will be broadcast live for 20 minutes and the most important information will be recorded in the live ticker.

This concludes the media conference. Thank you very much for your interest!
Football

Question: What happens if 900 people are let in during a football match?

For events with less than 1000 people, a risk assessment must be made with the authorities, says Berset. But it doesn't mean that events with less than 1000 people are always allowed.
Figures

Daniel Koch reads out the current status of coronavirus infected persons in Switzerland by canton: Ticino has two cases, Aargau one, Geneva three, Graubünden two, Obwalden one, Basel-Land one, Basel-Stadt one, Zurich two and the Canton of Vaud one. But each individual case is special.
estimated number of unreported cases

Question: Does the Federation expect a high number of unreported cases of infected persons?

No, says Koch. "So far we still discover most cases. But in the rest of Europe we expect a high number of unreported cases, especially in Italy. You have to take this into account when assessing the situation," says Koch.

In Italy it is probably no longer possible to always be able to prove the transmission chain without gaps, says Berset. The same applies to Germany.
Ban

Question: Are only events that take place in confined spaces affected by the measures?

No, says Berset. also the Bernese or Basel carnival.

And what about church services?

"The last time I attended a service with more than a thousand people was in Rome," says Berset. But the measures were initially valid for two weeks. Then everyone would have to decide for themselves what they wanted to do or not.
Tests

Question: Who pays for quarantine and testing? The health insurance company or the affected person himself?

"The tests are diagnostic tests, so they are paid for by the health insurance companies," says Daniel Koch. The quarantine measures would have to be paid for by the cantons. But since most people are in quarantine at home, this is not important at the moment.
Zurich HB

Question: What about transport hubs? At Zurich main station or Bern railway station? And what about shopping centres?

They wanted to ban major events, such as a concert. "Such events cannot be compared to a situation in a railway station," says Berset. Infection requires a distance of less than 2 metres for more than 15 minutes.
Berset in Italy

Question: Berset was in Italy last week. Did he also take a test?

Berset: "I show no symptoms. I feel fine."
Tests

The number of tests has risen sharply, says Koch. The number of tests has doubled again from yesterday to today alone. "The important thing is that there must be a plausible reason for someone being infected," says Koch. You don't test everyone with symptoms now.

Emergency law

Question: The Confederation also has the possibility of declaring an "extraordinary situation". What would be the difference between this and an extraordinary situation?

The extraordinary situation would be comparable to emergency law, says Berset. But there are clear criteria for this. The situation would be declared if Switzerland were in great danger. But even in the current, special situation, there are different levels of escalation, says Berset. "At the moment we are still at a low level."

Question: When would they close off entire towns or areas?

There is no reason for that, says Berset. You have to be very flexible to take the right measures at the right time - not too early and not too late.

Daniel Koch takes the floor: "Sealing off areas makes little sense. But in Switzerland, a great many people who also work in the healthcare sector commute. If hospital employees are no longer able to go to work or hospital staff cannot return home, it is counterproductive. "You have to look at every measure: "Is it really effective?"
Hardship clause

Question: Is there an assessment of the economic impact of the measures?

It is clear that there are economic consequences, says Berset. But the top priority is the health of the population. According to the Epidemics Act, however, the Confederation is not responsible for economic damage. There is a hardship clause for special persons, says Berset.
Ski resorts

Question: What is the situation in the ski resorts?

"This is again a situation where there are not a thousand people in a confined space on top of each other," says Berset. The current ban only applies to events where there are a lot of people in a small space. This does not apply to ski resorts.
Competencies

Question: Have the cantons delegated powers to the Confederation so that they do not have to take unpopular measures on their own?

"No", says Hanselmann. The cantons have proved that they are prepared to do everything they can to minimise the incidence of disease. But if the Confederation follows a uniform line, it will be easier and more timely to implement the measures. "I am aware that the decision also has financial implications," says Hanselmann. But the health of the population comes first.
Number of people

Question: Why was the number kept at 1000? What is the situation in public transport, for example on the train between Berne and Zurich?

As the Federal Council says, the number 1000 has something quite accidental about it. But they wanted to ban events with a large number of people. If someone there were to become infected, it was guaranteed that the chain of infection would be lost, and it would no longer be possible to trace who had had contact with whom. It was therefore reasonable to set this at 1000 people and not at 2000.

Berset: "And the situation in public transport is similar to that in the office. There it is still possible to take into account the hygiene measures that were recommended. Whether the session of parliament will take place in March is a matter for parliament to decide.
Finance

Question: Who will bear the financial consequences of these cancellations?

The law does not provide for financial compensation from the federal government, says Berset.
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  #1283  
Old 01.03.2020, 11:59
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Re: Coronavirus

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This is what happens when you only test people showing severe symptoms who came from high risk areas. You lose contact tracing real quick and it can spiral out of control. There's also the benefit of finding out how many recover alone which may balance out the high death rate.
I'd like to see a well-reasoned argument (not necessarily from you, but in general) on who all should be tested, and why. I've no problem with only testing people showing symptoms, otherwise we're spending a lot of time, money and resources on mostly healthy people. It's quite possible many people will get the virus and never know or have such mild symptoms they never report. But maybe that's short-sighted?

I might be on the wrong track, but looking at basic numbers this seems so blown out of proportion. China has a population of 1.3 billion, there are about 80,000 people who have tested positive, and about 2,800 deaths. That's an infection rate of 0.06% and a death rate around 3% of those infected.

Switzerland has a population of 8.5 million. If we scale China to here, it's reasonable to expect about 5,100 cases and 150 deaths. Is it a lot? Sure and it sucks if you're one of the unlucky families. It is enough that we need to panic or start testing every single person? No, not imo.

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...Only one trained person is needed to operate the machine which makes it possible to have one at the airport for instance, to do tests on the spot, much more efficient, and it's cheap, a few hundred HKD, so i guess less than 100chf...
This is pretty cool, and if it really works could be a great tool in the toolbox. Again, it raises the question of who needs to be tested? Do we make every arrival at every international airport get tested and wait around for an hour for the results? Do we rely on self-reported surveys? No officer, I have not been in Italy, I swear.

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I'm so grateful schools are still open. Teachers have been receiving instructions from their canton on how to be proactive (hygiene procedures) and reactive (recommend immediate GP consultation when they suspect Coronavirus symptoms).

It has also been recommended to avoid traveling to North Italy for the time being.

As if teaching isn't hard enough....
Mr Wishes was watching a press conference yesterday. The official speaking said it was NOT a good idea to close schools here, because then all the children (who don't seem to be impacted by the virus as much) would simply go to the grandparents (who seem to be a higher-risk category). Makes sense to me, at least for CH.

Edit - The last bit about grandparents is also covered in more detail by Blueangel's post above
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  #1284  
Old 01.03.2020, 12:06
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Re: Coronavirus

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I might be on the wrong track, but looking at basic numbers this seems so blown out of proportion. China has a population of 1.3 billion, there are about 80,000 people who have tested positive, and about 2,800 deaths. That's an infection rate of 0.06% and a death rate around 3% of those infected.
That's just such a wrong way of looking at him.

You just can't quote an infection rate of 0.06%. It doesn't work like that. You haven't taken into account incubation times, the number of people who have been exposed to the virus and have yet to pass it on to someone else (or several people) and so many other factors.

If no-one else gets it in China then perhaps, in a year's time, if your figure is still the same then there would be more truth in it.
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Old 01.03.2020, 12:09
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Re: Coronavirus

From the speech:

"Infection requires a distance of less than 2 metres for more than 15 minutes"


Yeah right...
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Old 01.03.2020, 12:24
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Re: Coronavirus

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I might be on the wrong track, but looking at basic numbers this seems so blown out of proportion. China has a population of 1.3 billion, there are about 80,000 people who have tested positive, and about 2,800 deaths. That's an infection rate of 0.06% and a death rate around 3% of those infected.

Switzerland has a population of 8.5 million. If we scale China to here, it's reasonable to expect about 5,100 cases and 150 deaths. Is it a lot? Sure and it sucks if you're one of the unlucky families. It is enough that we need to panic or start testing every single person? No, not imo.
That is when assuming the Chinese numbers are correct, which hardly anybody believes. Also the numbers hardly show any consistency In Hubei they have on average about one death per 11 recoveries, Henan about 1 death per 55 recoveries and it is best to get the disease in Zhejiang they report only 1 death per 1046 recoveries. Even Italy that has 1.128 reported infections and in general a much better healthcare system than China is currently already at 29 deaths and only reported 46 recoveries (also explained by the fact that Italy started later and it might take more time before being declared recovered, but they have like 28 times as much death and more to come)

The numbers from China just make no sense at all.
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Old 01.03.2020, 12:26
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Re: Coronavirus

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That's just such a wrong way of looking at him.

You just can't quote an infection rate of 0.06%. It doesn't work like that. You haven't taken into account incubation times, the number of people who have been exposed to the virus and have yet to pass it on to someone else (or several people) and so many other factors.

If no-one else gets it in China then perhaps, in a year's time, if your figure is still the same then there would be more truth in it.
I don't disagree, I'm just extracting basic data and making comparisons to decide if we need to panic and go to our bunkers.

What's interesting is the Swiss numbers keep moving about. Yesterday it was 14 or 15 cases depending on the source. Today's map shows 21 cases in CH.
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Old 01.03.2020, 12:34
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Re: Coronavirus

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I don't disagree, I'm just extracting basic data and making comparisons to decide if we need to panic and go to our bunkers.

What's interesting is the Swiss numbers keep moving about. Yesterday it was 14 or 15 cases depending on the source. Today's map shows 21 cases in CH.
Media publishes after first test, Government only considers it official if the reference lab in Geneva has confirmed it, but both use both numbers without always stating what is official and what is awaiting reference results, and there is some time between those tests making it confusing to get the actual current numbers.
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Old 01.03.2020, 12:36
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Re: Coronavirus

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I'd like to see a well-reasoned argument (not necessarily from you, but in general) on who all should be tested, and why. I've no problem with only testing people showing symptoms, otherwise we're spending a lot of time, money and resources on mostly healthy people. It's quite possible many people will get the virus and never know or have such mild symptoms they never report. But maybe that's short-sighted?

I might be on the wrong track, but looking at basic numbers this seems so blown out of proportion. China has a population of 1.3 billion, there are about 80,000 people who have tested positive, and about 2,800 deaths. That's an infection rate of 0.06% and a death rate around 3% of those infected.
Anyone can look at the basic numbers provided these numbers are correct. I doubt they are. Look how different they are in China and Italy, same virus.

The wrong track of stats interpretation is logical and probable by those in uncompromised categories.

People are getting tested to prevent the spread. As it is, one cannot really efficiently prevent it hence the authorities not testing en mass.

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This is pretty cool, and if it really works could be a great tool in the toolbox. Again, it raises the question of who needs to be tested? Do we make every arrival at every international airport get tested and wait around for an hour for the results? Do we rely on self-reported surveys? No officer, I have not been in Italy, I swear.
Exactly what TelMed or Medicins de garde do already. Inefficiently, if you ask me for my own experience. These long distance complicated algorithms and awkward decision trees cannot replace real diagnosis. They are done to have patients trickle to the ERs not pour in, make the journey longer. The virus will not care.

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Mr Wishes was watching a press conference yesterday. The official speaking said it was NOT a good idea to close schools here, because then all the children (who don't seem to be impacted by the virus as much) would simply go to the grandparents (who seem to be a higher-risk category). Makes sense to me, at least for CH.
Aha. Because they don't see them now? They do and soon they will show up at grandparents for Sunday lunch, asymptomatically contagious.
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Old 01.03.2020, 12:42
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Re: Coronavirus abroad

The Hippocratic oath is about medical ethics. First do no harm etc etc. Though I believe the wording has been updated. It's a cross-border professional oath, not country specific.

Not sure what help a bunch of very retired docs could be if they aren't up to date on the standards and practices etc. Plus most would be in the at risk category, presumably.
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Old 01.03.2020, 12:50
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Re: Coronavirus abroad

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The Hippocratic oath is about medical ethics. First do no harm etc etc. Though I believe the wording has been updated. It's a cross-border professional oath, not country specific.

Not sure what help a bunch of very retired docs could be if they aren't up to date on the standards and practices etc. Plus most would be in the at risk category, presumably.
Country specific. Some countries require it for licensing MDs.

Ethics, of course - you cannot check out the duty when situation calls for you. Ie. if able but retired, you will be summoned. Or if on hols or absence. Aside of moral duty, there is legal obligation.
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Old 01.03.2020, 12:51
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Re: Coronavirus & other pandemic like virus's - Medical staff conscription on the car

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In my home country, as an MD you take a Hippocratic oath as a part of the grad ceremony. Which means even when retired (or on holidays), in case of public health crisis the MDs have a duty to present themselves where they are needed (if their own health allows). The pandemic plans have been ready for a long time.
I’ve not heard of an MD anywhere who hasn’t taken the oath. Here’s an example in English.

I swear to fulfill, to the best of my ability and judgment, this covenant: I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

As I understand it, this is a non binding ethical statement.

Whether or not out of duty MD’s assist has to do with legal structures, liability etc in a given country, less than the Hippocratic oath, I think. Although, not being familiar with every country, some expectation of service may be implied. Is it legally binding in your country?
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Old 01.03.2020, 12:54
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Re: Coronavirus

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Yak.
So jackets go into the daily wash with the underwear now.


You have to ask? When this Corona-thing is over, we shall pave all roads, sidewalks, parking lots (you will have to do it with your own drive-way) new, we wash the lawns (each grass will be disinfected by hand), so will the flowers be (bee friendly stuff must be used), the houses will be washed down and the window cleaners will do 24h shifts. And remember to do the roofs first or you'll have to start all over again. TIS.
That's pretty standard in Switzerland, isn't it? Which other country demand that engine and chassis of the car be washed before the technical control??
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Old 01.03.2020, 13:18
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Re: Coronavirus abroad

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Country specific. Some countries require it for licensing MDs.

Ethics, of course - you cannot check out the duty when situation calls for you. Ie. if able but retired, you will be summoned. Or if on hols or absence. Aside of moral duty, there is legal obligation.
Legal obligation for those on holiday to return if the work has an urgent need for this, yeah sure. Such is covered by law. But there is absolutely nothing forcing retired people to return to work, we got rid of slavery.
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Old 01.03.2020, 13:21
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Re: Coronavirus

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I'd like to see a well-reasoned argument (not necessarily from you, but in general) on who all should be tested, and why. I've no problem with only testing people showing symptoms, otherwise we're spending a lot of time, money and resources on mostly healthy people. It's quite possible many people will get the virus and never know or have such mild symptoms they never report. But maybe that's short-sighted?

I might be on the wrong track, but looking at basic numbers this seems so blown out of proportion. China has a population of 1.3 billion, there are about 80,000 people who have tested positive, and about 2,800 deaths. That's an infection rate of 0.06% and a death rate around 3% of those infected.

Switzerland has a population of 8.5 million. If we scale China to here, it's reasonable to expect about 5,100 cases and 150 deaths. Is it a lot? Sure and it sucks if you're one of the unlucky families. It is enough that we need to panic or start testing every single person? No, not imo.
...


Mr Wishes was watching a press conference yesterday. The official speaking said it was NOT a good idea to close schools here, because then all the children (who don't seem to be impacted by the virus as much) would simply go to the grandparents (who seem to be a higher-risk category). Makes sense to me, at least for CH.

Edit - The last bit about grandparents is also covered in more detail by Blueangel's post above
The problem with looking at Chinas infection numbers is they are taking extensive measures in preventing, from monitoring temperature of people leaving homes and before they enter buildings, recording names and contact information of people eating out so they can be traced and quarantined in case they retroactively find someone was sick, arresting people who aren't wearing masks, and keeping business to a minimum. You can't look at their low infection rate while they are using extreme measures and assume we'd have the same infection rate with business as usual.

It's a valid point about the grandparents, but you also have to assume that many of these children are spending time with their grandparents anyhow so you have all the kids who are terrible with hygiene packed together for hours every day in school, and then spreading across families. The kids might not be at risk themselves, but they are more likely to help it spread across families.
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Old 01.03.2020, 13:29
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Re: Coronavirus

Your advice/thoughts. We are booked into a Spa resort in the Valais in 2 weeks. At this time of year, lots of South Koreans and Italians (Loèche-les-Bains/Leukerbad).

Hot water at 45 ish, saunas, steamrooms and jakuzzis. Good idea?
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Old 01.03.2020, 13:39
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Re: Coronavirus

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Your advice/thoughts. We are booked into a Spa resort in the Valais in 2 weeks. At this time of year, lots of South Koreans and Italians (Loèche-les-Bains/Leukerbad).

Hot water at 45 ish, saunas, steamrooms and jakuzzis. Good idea?
If you live your life in fear, the virus has already won. Don't negotiate with terrorists.

I wouldn't go though. lol.
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Old 01.03.2020, 13:45
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Re: Coronavirus

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Your advice/thoughts. We are booked into a Spa resort in the Valais in 2 weeks. At this time of year, lots of South Koreans and Italians (Loèche-les-Bains/Leukerbad).

Hot water at 45 ish, saunas, steamrooms and jakuzzis. Good idea?
That sounds a bit racist. I thought anyone could have it regardless of nationality.
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Old 01.03.2020, 13:50
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Re: Coronavirus

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Your advice/thoughts. We are booked into a Spa resort in the Valais in 2 weeks. At this time of year, lots of South Koreans and Italians (Loèche-les-Bains/Leukerbad).

Hot water at 45 ish, saunas, steamrooms and jakuzzis. Good idea?
Honestly, very bad idea, high traffic wet areas, body fluids on every surface...
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Old 01.03.2020, 13:53
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Re: Coronavirus abroad

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Country specific. Some countries require it for licensing MDs.

Ethics, of course - you cannot check out the duty when situation calls for you. Ie. if able but retired, you will be summoned. Or if on hols or absence. Aside of moral duty, there is legal obligation.
All countries AFAIK know have this oath.

A legal obligation to be summoned out of retirement? That cannot be accurate, surely. Or at all legal. No qualified physician would ever truly be able to leave their job or switch professions. On a sticky wicket in some countries too if on holiday. Can ask and be recompensed in some way but an order?

The police in the UK, and I presume elsewhere, can have leave cancelled in emergency situations but I can imagine they'd be required to fly home from a family hol. I'll ask my neighbour when I see her. Retired DCI.
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