Discover and read the best of Twitter Threads about #handsfacespace
Most recents (24)
COVID sitrep: It’s clear to anyone following the news that we are expecting a very large wave of COVID-19 infections, driven by the new omicron variant. Very unwelcome news and we aren’t certain how well vaccination will protect us. Here’s what’s happening in NHS hospitals… 1/14 
The first thing to say is that when do a PCR test for COVID, we only get a positive or negative. The genotyping tests which tell us which variant take longer, and we aren't routinely sent them. So we don’t know in real time whether we are treating omicron or delta. 2/14
We are all looking at the graphs of new SARS CoV-2 ‘cases’. Like it or not, we face a huge wave of infections. Yesterday 93,000 people tested positive which is already well past the January 2020 peak of 81,000. 3/14
COVID sitrep: The situation in NHS hospitals hasn’t changed much since last week. A worry in itself. The number of patients admitted to hospital with COVID-19 continues to rise slowly. The current COVID wave now seems certain to combine with winter pressures in November. 1/10
The daily number of COVID infections continues to trend steadily upwards, as does the number of patients admitted to hospital. This means the NHS COVID workload is building. 2/10
It takes a long time to recover from severe COVID. Patients stay in hospital for some time. The NHS workload is best reflected in the number of patients in hospital, which remains high. Even if this turned round soon, many patients would still be in hospital in December. 3/10
COVID sitrep: On call this weekend and the pandemic grumbles on. Where I work in east London we are seeing lots of unvaccinated patients, many needing intensive care. Locally and nationally, hospital patient numbers are rising but slowly. The NHS COVID workload remains high. 1/10
The daily number of COVID infections continues to trend steadily upwards, but the number of patients admitted to hospital is rising more slowly. 2/10
The NHS COVID workload is best reflected in the number of patients in hospital which is also rising slowly. Numbers are smaller than the winter peak that caused such huge disruption. In this wave we are dealing with COVID but we’re trying to run all other services as normal. 3/10
COVID sitrep: Last week I reported the news that we feel we’ve passed the high water-mark for this wave in the UK. But this week expert epidemiologists have been discussing how infections are rising once more. So what’s happening on the ground? 1/10
.....this graph helps to explain. The number of COVID infections chatters up and down but the number of patients in hospital (our COVID-19 workload) is currently holding steady. Nothing like the winter peak of nearly 40,000 patients but still a lot of patients to look after. 2/10
This fits with this week’s independent data from @ICNARC which focuses on admissions to Intensive Care. The number of COVID patients in Intensive Care is holding steady (so far). The national picture fits with what colleagues are seeing in hospitals around the UK. 3/10
COVID sitrep: We are now fairly confident we have passed the high water-mark for this latest wave in the UK. Both infection rates and hospital admissions in decline. Good news but the NHS faces several competing major challenges as we look towards another difficult winter. 1/8
The daily number of COVID infections is consistently falling, and now the number of patients admitted to hospital each day with COVID-19 is on a downward trend as well. 2/8
Meanwhile, admissions to Intensive Care with COVID seem to be levelling off and possibly even beginning to fall as well. The national picture fits with what colleagues are seeing in hospitals around the UK. 3/8
COVID sitrep: As infections rise exponentially the NHS is again reconfiguring for COVID hospital admissions. This week in the hospital where I work we re-opened our temporary ‘surge’ intensive care unit. The link between infection and serious illness is weaker but not broken 1/10
This from a one my nursing colleagues. It is heart-breaking to think we will again see significant numbers of patients in Intensive Care, and more deaths from COVID-19. 2/10
The virus is all around us. >50,000 infections yesterday. This is why so many are being notified of contacts by the NHS app. Frustrating that newspapers casually call this a ‘ping-demic’ as if it were a software glitch. These are real infections; some will cause real deaths. 3/10
COVID sitrep: The latest UK wave continues to grow. The good news is (compared to previous waves) there are definitely fewer hospital admissions in relation to the number of infections. But the number of infections is now very large. TLDR: The link is weaker but not broken. 1/10
We are still seeing a significant number of people who need hospital care for COVID. They are mostly people who have not yet been vaccinated. A few have medical problems that leave them at greater risk of infection. Others are young and previously fit & well. 2/10
The daily number of new COVID cases in the UK continues to rise (now more than 35,000/day) and is bigger than the November peak. We expected a peak of infections in late July but as we are relaxing not tightening public health measures, the timing is now harder to predict. 3/10
1/ Tragically I can @carolecadwalla.
From the v start of the pandemic, #PHE have made a number of decisions that have definitely NOT been in the public’s or healthcare workers’ interest & will have resulted in many more lives lost or irrevocably damaged than was necessary.
From the v start of the pandemic, #PHE have made a number of decisions that have definitely NOT been in the public’s or healthcare workers’ interest & will have resulted in many more lives lost or irrevocably damaged than was necessary.
2/ Downgrading #COVID19 from the list of HCIDs was one such example.
Few HCWs doubt that the decision was based on supplies of #PPE available.
Anyone in doubt should try to watch this @BBCPanorama by Richard Bilton which is bizarrely no longer available?!
Few HCWs doubt that the decision was based on supplies of #PPE available.
Anyone in doubt should try to watch this @BBCPanorama by Richard Bilton which is bizarrely no longer available?!
3/ @DrRCoull & I were 2 of many GPs who raised concerns last yr over the LEVEL of #PPE HCWs expected to wear when dealing directly w/ confirmed or suspected #COVID19 pts.
@drmeenalviz @ThePalpitations @DAUK_GP & @EveryDoctorUK @DrSimonHodes +others REPEATEDLY RAISED THE ISSUE
@drmeenalviz @ThePalpitations @DAUK_GP & @EveryDoctorUK @DrSimonHodes +others REPEATEDLY RAISED THE ISSUE
1/5
Every day at home is helping to stop the spread of #COVID19 in the capital.
We've come a long way in London over the past few months and that is down to all of us making sacrifices. However, we know how quickly cases can rise so let's keep going!
Every day at home is helping to stop the spread of #COVID19 in the capital.
We've come a long way in London over the past few months and that is down to all of us making sacrifices. However, we know how quickly cases can rise so let's keep going!
2/5
It's still vital that everyone remains at home while the national lockdown continues.
Doing this will allow us to be in the best possible place when further restrictions lift on 29 March and when decisions are made about step 2 of the roadmap.
#KeepLondonSafe
It's still vital that everyone remains at home while the national lockdown continues.
Doing this will allow us to be in the best possible place when further restrictions lift on 29 March and when decisions are made about step 2 of the roadmap.
#KeepLondonSafe
3/5
Latest @ONS data shows the proportion of working adults leaving home for work in the last 7 days increased by 5% to 53% this week.
Latest @ONS data shows the proportion of working adults leaving home for work in the last 7 days increased by 5% to 53% this week.
New coronavirus infections are decreasing and 14 million people in the UK have received one vaccine dose. But the sitrep is that hospitals are still caring for 24,352 COVID patients – more than at the peak of the first wave. NHS staff cannot rest yet. 1/8 bbc.co.uk/news/health-56…
Despite the absurd claims of COVID sceptics, we have seen a huge number of excess deaths in the past 12 months, and well above the five-year average mortality rate. COVID remains the leading cause of death right now – many amongst working age people. 2/8
The pressure on the NHS remains extremely high and will be for months to come. This by @Zudin_P and @stevemathieu75 for @ICS_updates describing the vast effort needed to create extra Intensive Care beds across the UK. We still have more ICU patients than the first wave. 3/8
Sitrep: situation report. This is what we call our daily briefings right now. Here’s mine. We are now fairly confident we have reached the high water-mark for the second wave of COVID-19 NHS hospital admissions across the UK. Good news but.... 1/10
....we still have nearly 40,000 patients in hospitals with COVID-19. Despite huge increases in staffing, we are very short-handed. In many hospitals, admissions have stabilised but not all. Some differences across the UK. Things still getting worse in the Midlands and North. 2/10
4000 of these patients (10%) need intensive care. This is huge: in January 2020 the UK had only 4100 adult ‘critical care’ beds including both ‘intensive care’ ventilated beds for the sickest patients and 'high dependency' beds for less sick patients. 3/10
kingsfund.org.uk/publications/c…
kingsfund.org.uk/publications/c…
Optimistic news: National data on new coronavirus infections data do now show we have passed the peak. Good news but really this is just the end of the beginning for the NHS response. 1/7
Firstly, the national data hide regional differences. New infections are still increasing in many parts of the UK. NHS hospitals in different areas will need to support each other for some time to come. 2/7
This map illustrates this much more clearly. Many areas of the country still very badly affected by new infections. This affects NHS healthcare in pretty much every part of the UK. 3/7
Lots of doom scrolling this evening, so I thought I would share some positive thoughts, after spending the afternoon prescribing in our covid vaccine clinic.....
The Pfizer vaccine has been through all the phases of safety trials, and the data scrutinised by the regulators. It is safe. This article helps explain how it jumped all these hurdles and got to patients so quickly... theguardian.com/society/2020/d…
It is a tricky vaccine to work with! It needs very cold storage, can only be moved a few times and it tricky to draw up. Our pharmacists (legends) have been drawing up 0.3ml doses into syringes all day, over 300 times per day 😳
Situation in London continuing to deteriorate as expected. Many doctors are worried that other parts of the UK will follow. A lot of misinformation around, so some fairly blunt observations here, for which I apologise. But we all need to understand the equation. 1/10
As with the first wave, the sharp rise in people testing positive for SARS-CoV-2, will be followed by a sharp rise in hospital admissions for COVID-19, and then a similar rise in excess deaths in January.... 2/10
….but like all disasters, for every death we can expect many more people to be injured and survive. And so it is with COVID-19. Most hospitalised patients will survive but they will take a long time to recover. Many will experience so-called ‘Long COVID’. 3/10
News of the lockdown was greeted with grim relief by NHS staff on Saturday. On the one hand, it will ease the pressure on hospitals affected by COVID-19. On the other, everyone’s Christmas is affected including NHS staff, many of whom live away from their families. 1/5
NHS hospitals are under huge pressure and expect to remain so until well into January. The number of people testing positive for the virus SARS-CoV-2 has risen sharply and so have hospital admissions with the disease COVID-19. 2/5
The south-east England and south Wales are worst affected but now some areas of the midlands are seeing high numbers of positive tests as well. With news that the new virus mutation is more infectious, we should prepare for a rebound rise across the UK. 3/5
There are several reasons to think that the new UK #SARSCoV2 variant is an important one as it might be more contagious than other variants, but there are also some uncertainties. So much misinformation is being circulated, so this thread brings key data together. 🧵
1- Genomic data
In the UK, COG-UK undertakes sequencing of SARS-CoV-2 samples from ~ 10% of positive cases. This is an enormous effort, and helps scientists to identify mutations and track them over time. Here are some variants being tracked in the UK. 1/ cogconsortium.uk/wp-content/upl…
In the UK, COG-UK undertakes sequencing of SARS-CoV-2 samples from ~ 10% of positive cases. This is an enormous effort, and helps scientists to identify mutations and track them over time. Here are some variants being tracked in the UK. 1/ cogconsortium.uk/wp-content/upl…
Over time, scientists have identified this new variant, called B.1.1.7 or VUI – 202012/01 (the first Variant Under Investigation in December 2020), which looked different than others. It has acquired 17 mutations compared to its most recent ancestor. 2/ virological.org/t/preliminary-…
On the intensive care unit today covering a colleague who is unwell, so only time for a brief update this week. You may have seen a lot of coverage that London hospitals are very badly affected by COVID-19 right now. This is all pretty accurate I’m afraid. 1/10
Hospitals in the north of England seem to be stabilising now which is a relief, but the situation in south Wales, east London and the north Kent remains very difficult. COVID patient numbers have doubled where I work in the last week. 2/10
Compared to the first wave, we are looking after a much larger number of patients with ‘usual’ illnesses. Heart attacks, strokes, trauma, cancer surgery etc. NHS staff are getting pulled in lots of directions. 3/10
Spoke too soon. Two weeks ago I was hopeful that the second COVID tide was starting to turn. Things weren’t easy but had stabilised and national numbers were down. Now we're seeing rising numbers at national level in and several regions, including where I work in east London. 1/7
The number of people testing positive for SARS Cov-2 is definitely up in the last 7 days, while the number of patients admitted to hospital with COVID-19 is beginning to rise, and the number of deaths (which lags behind admissions) was falling but has now levelled off. 2/7
Government data fit with the independent data from @ICNARC describing intensive care admissions. The number of patients in ICU with COVID-19 appeared to be falling 7 days ago but not any more. 3/7
Themes of the week: vaccine roll-out, the COVID tide turning, and the lockdown ending. This is where I think we’re at, having talked again with friends across the UK and compared this all with the national data. 1/9
Friends in many (not all) badly hit hospitals tell me the second COVID tide is beginning to turn. BUT the NHS is still really busy keeping surgery services going, as well as winter pressures of acute medical admissions, and then COVID on top of all that. 2/9
News from ground level fits with the national data which show a consistent decrease in numbers of people testing positive for SARS CoV-2, a decrease in patients being admitted to hospital with COVID-19, and in subsequent deaths. 3/9
Fantastic news that the first COVID-19 vaccine has been approved for routine use so quickly. Here is why I am happy to be vaccinated and why I want my family and friends to have a vaccine too... 1/10 #InjectionforProtection #DocsforVax
bbc.co.uk/news/health-55…
bbc.co.uk/news/health-55…
Widespread vaccination was always our best and only route out of the pandemic. The fewer people who carry the virus, the slower it can spread. By being vaccinated, we protect not only ourselves but our family, friends, work colleagues and so on, even strangers on the bus.... 2/10
The UK has one of the best and strictest drug regulatory processes in the world. Testing new drugs is a thing we are really good at. Anyone who has worked on a clinical trial will vouch for the rigour and safety of @MHRAgovuk and @HRA_Latest processes. 3/10
🚨New #IndieSAGE paper🚨
1. From Stay Home to Stay Alert, UK government messaging has been much discussed during the #COVID19 pandemic. #IndieSAGE has analysed its effects (March-Oct 2020) and makes recommendations for a communication reset.
🔗bit.ly/3kBrpp6
🧵
1. From Stay Home to Stay Alert, UK government messaging has been much discussed during the #COVID19 pandemic. #IndieSAGE has analysed its effects (March-Oct 2020) and makes recommendations for a communication reset.
🔗bit.ly/3kBrpp6
🧵
2. It is through language that #COVID19 laws, regulations, rules, and guidance are written - which must be understood, interpreted, and acted upon by people. Precise messaging is easier to understand and act upon.
For instance, what counts as 'mingling'?
(@AdamWagner1)
For instance, what counts as 'mingling'?
(@AdamWagner1)
3. While 90% of people believed that “Stay home, protect the NHS, save lives” was clear, "Stay Alert" was immediately challenged, rejected by other UK nations, criticized, satirized, and - crucially - not understood by 65% of people.
A lot of new data out on treatments for COVID-19. Updating a previous thread with what we know now. Still lots of research ongoing and a few things may change. Much of this world leading research is taking place in the UK, funded and delivered by @NIHRresearch. 1/20
Dexamethasone: A simple steroid drug widely used in many diseases. Shown in @NIHRresearch RECOVERY trial to improve survival for respiratory failure due to COVID-19 (i.e. severe cases only). Probably acts by reducing lung inflammation. 2/20
Hydrocortisone: Another widely used steroid drug. May help systemic (whole body) inflammation in critical (life threatening) illness which some call 'cytokine storm'. @NIHRresearch funded @remap_cap trial suggests benefit in ICU patients but weaker signal than dexamethasone. 3/20
A bit of recent history: The first SARS epidemic in 2002-4 was caused by the virus SARS-CoV which is very similar to the virus causing the current pandemic. The story of the outbreak of SARS in Hong Kong courtesy of Wikipedia: en.wikipedia.org/wiki/2002%E2%8… 1/5
On 21st February 2002, Liu Jianlun and his wife checked into a room on the ninth floor of the Metropole Hotel in Hong Kong. Liu was a doctor at a hospital in Guangdong, China where he had looked after SARS patients. 2/5
Despite feeling ill, he attended a family wedding and they travelled around Hong Kong. By 22nd February he knew was very sick so he walked to the nearby Kwong Wah Hospital. On arrival, he warned staff about his illness and that he should be put in isolation. 3/5
I'm going to discuss this with you, working on the assumption that you are a good person who is either poorly informed or has misunderstood the data. Please be respectful though (not everyone is).
1. There is a second wave but as the graph nicely shows, the rate of growth is much slower this time. Believe me, we are all very relieved about that. But a few ICUs eg Liverpool are already stretched to the limit.
2. I totally give credit to lockdown measures and #HandsFaceSpace for this. Tweet 6/6 in my thread makes that very clear and also our gratitude to everyone for working so hard to make that happen.
