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This is the key terrifying graph from the latest @imperialcollege #covidー19uk modelling. The red line right at the bottom is the max number of ICU beds. Note, that we've been on the "do nothing" upper black line trajectory until pretty much today
This is what exponential growth looks like. A rocket taking off. So much was fudged & obfuscated today, but Johnson did say we have entered the "acceleration" period. Notice how on the graph, we are still safely under the red line right now...
Vital interventions that could have been taken have not been taken. Look at the curve. Actions matter. But mass events - @stereophonics concerts! - were held this w'end because of lack of govt leadership. It has to be held to account & today's press conference was v worrying eg
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Carole Cadwalladr
@carolecadwalla
“Dominic Cummings became convinced that Britain would be better able to resist a lethal second wave...if Britain developed ‘herd immunity’ “

Hold. This. Government. To. Account Image
Cummings needs to go before a select committee ON MONDAY to answer to this. If true, it is not just a catastrophic misjudgment on the part of a wayward aide that in all likelihood will cause 1000s extra deaths. It is a catastrophic misjudgement of Johnson to invite him into govt
‘At a private engagement at the end of February, Cummings outlined the government’s strategy. Those present say it was “herd immunity, protect the economy and if that means some pensioners die, too bad”.’
Read 3 tweets
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Carole Cadwalladr
@carolecadwalla
‘The minister told BuzzFeed that Cummings and Vallance were “close allies” and claimed the govt had “bet” the future of the UK on advice from a very small group of scientists that differed from the wider international consensus, and other members of SAGE’
buzzfeed.com/alexwickham/10…
‘There was no consensus. Several of the scientists frantically argued that the UK must immediately introduce social distancing to halt the spread of the virus. Some pleaded with the government to change tack or face dire consequences.’
Alarm bells of those of us who spent 3 years trying to hold Johnson & Cummings to account began ringing wildly alongside unlikely allies Rory Stewart & Jeremy Hunt. We were lambasted for playing ‘politics’ while it felt like press was in dangerous trance. And so it turns out
Read 4 tweets
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Carole Cadwalladr
@carolecadwalla
If you are an MP, please take seriously your duty to scrutinise this bill today. We need to respond to this emergency. But we also need to carefully balance the threat to our civil rights from sweeping new powers to arrest, detain, surveil for next 2 years
gov.uk/government/pub…
Why is it for 2 years? The government is not revealing information suggesting it believes this crisis will last 2 years. Why the discrepancy? And if it's not telling us stuff now, this bill will give it powers to tell us not much more stuff in the future.
I'm v concerned about how data will be used. What data will not be revealed to us - as is happening now. And what data will be taken from us - to surveil & monitor us. I'm keeping this v v measured but if you've followed me for last 3 years, you'll know the basis for my concerns
Read 7 tweets

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ISN Education
@ISNeducation
#COVID19 for the Nephrologist- Real life experience from Italy @caioqualunque Webinar now available on the ISN Academy
@caioqualunque Thank you for sharing your experience with the ISN community. On the panel ISN President @vjha126 Moderator @arvindcanchi. ISN education highlights by @gag_aggarwal
@caioqualunque STORY OF THE EPIDEMIC-Feb14 38yr old Italian starts with symptoms after being asymptomatic for weeks->Feb 20 only 3cases->fast forward to 2 weeks later the country is in lockdown #COVID #COVID2019italia #COVID2019india #COVID2019 #nCoV2019 #Covid_19
Read 39 tweets
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Paul Nuki
@PaulNuki
IMPORTANT. Here is the modelling behind the UK Govs #covidー19uk strategy.

Big choice ahead: 1/Mitigation: 250k deaths, or 2/Suppression: 20k deaths but with a lockdown that ends only once a vax or treatment found.

imperial.ac.uk/media/imperial…
Both strategies have much the same mix of measures, all of which were announced tonight by the PM. The big difference is they are not lifted in the suppression option. My guess is government will now play it by ear - how long can Britain change its behaviour for
The hard fact driving these hard choices is NHS surge capacity. Remember that lovely 'flatten the curve' graphic the Economist put round with health capacity as a horizontal line across the middle? Well, it was right except in UK that line is at the bottom. Here's the real thing:
Read 7 tweets
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Stefan Simanowitz
@StefSimanowitz
@peterjukes @BorisJohnson 1/. It was actually TEN days ago that @BorisJohnson first mentioned the ‘take in on the chin’ theory.

He told it to @Schofe & @hollywills on #ThisMorning on Thursday, 5 March.

A clip of him saying this was tweeted by @mvdct on the same day.

What happened next was remarkable...
@peterjukes @BorisJohnson @Schofe @hollywills @mvdct On Sunday evening, after a tip off from @CereinynOrd (follow her for #coronavirus), I tracked down the clip of the interview.

The clip beings with Boris saying: "One of the theories is, that perhaps you could take it on the chin, take it all in one go..."
@peterjukes @BorisJohnson @Schofe @hollywills @mvdct @CereinynOrd 3./ He goes on: "...& allow the disease, as it were, to move through the population, without taking as many draconian measures. I think we need to strike a balance."

To me there were two possible explanations for what Boris had said.

The second far more chilling than the first.
Read 39 tweets
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Helmy Haja Mydin
@dochelmy
My fellow Malaysians 🇲🇾

Pls RT if you can.

I want this message re #COVIDー19 to go out.

Many of the people in power are too afraid of making the difficult but right decisions. They are thinking as politicians, not as leaders.

#SocialDistancingNow
COVID19 cases will increase. A lot. Although the virus itself hasn’t changed, people will start dying if there are insufficient critical care beds.

There are less than 1000 ICU beds in all of Malaysia. If the numbers spike, our healthcare system will be overwhelmed.
We will start to convert wards to ICUs, doctors and nurses will drop from exhaustion, choices will have to be made re who gets life support and who doesn’t.

That’s why social distancing is essential - it will slow growth & buy us time. In some cases, enough time to save lives
Read 5 tweets
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Jon Worth
@jonworth
Right. I have been trying to get my head around the UK Government's #CoronaVirus approach for the past few hours.

Here follows a thread that's a summary of my thinking. Open workings if you like.
🚨 I am *not* a medical professional, so treat all of this with extreme care 🚨

I do however have some core questions about the UK Government's approach, and whether it actually fails on its own terms, and that's what I'll examine.
Before going any further, read this thread which is the best summary of the UK Government's approach I have found, and explains the overall aims:
Read 16 tweets
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Ameya Kulkarni, MD
@ameykulkarnimd
Lots of talk about the expected surge in ICU and hosp beds with #COVID. I’ve been hearing about reducing elective case burden (great thread from @ajaykirtane about that). We should also be rethinking our hospital approach to conditions that will continue in the covid era 1/n
Most obvious is with #STEMI care. If your hospital doesn’t have an ED bypass protocol for stemis - probably a good time to develop one. Ours at @VHC_Hospital has 1 min pitstop in ed w ems txp to cath lab - less pt exposure time to ED and less burden on ED resources 2/n
Also with #STEMI care - No icu for stable pts w normal EF should be standard. For most of these pts ICU is not necc and creates unneeded exposure for pt and occupies much needed ICU beds. (I think @agtruesdell had a great thread on this a while back) 3/n
Read 11 tweets

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