Thread by @lower_baseline

#COVID19 is overwhelming health systems – wondering how to protect our #NHS and staff on the frontline? Do we need these radical measures to #FlattenTheCurve & #ScaleUpCriticalCare? YES. And we may need much more 👇👇 (1/17)

What we're doing already:

Social distancing & testing to #FlattenTheCurve & increase #NHS capacity --> more intensive care beds

IN ADDITION:

We need to #LowerTheBaseline NHS demand - emergency public health interventions CAN help (2/17)

We have all heard ‘prevention is better than cure’. Did you know prevention could also protect you from #COVID19, reduce pressure on our stretched #NHS and help protect staff on the frontline? (3/17)

Not all hospital admissions are avoidable, but some are. We need to reduce the major avoidable drivers of acute hospital admissions – injuries, heart & lung disease, frailty and diseases of poverty. (4/17)

What could Governments do?

- Reduce speed limits

- Unprecedented stop smoking for #COVID19 campaign - with FREE nicotine replacement therapies for all

- Extend winter fuel allowance for the >70 year olds

- TV-based home exercises

- Extend minimum unit alcohol pricing (5/17)

In England alone we have over 35,000 non-deadly hospital admissions due to road traffic accidents every year. More than 10% need intensive care, including ventilators. Lower speeds decrease accidents and reduce major injuries. (6/17)

People who walk and cycle always need to be protected. Especially now as people avoid public transport in order to follow UK government advice on #SocialDistancing. (7/17)

City Mayors, local authorities and devolved governments have powers to make some of these changes: @TfL has recently reduced the speed limit to 20mph on all @TfL owned roads – can this be extended to the rest of London @MayorofLondon and across the UK? @LGAcomms @V0LDN (8/17)

Why reduce tobacco #smoking?

Smoking --> half a million hospital admissions per year (22% of all admissions!)

Now is the best time to stop --> protect yourself from #COVID19 & support our #NHS services

blogs.bmj.com/bmj/2020/03/20… @AshOrg @phe @MattHancock (9/17)

>70 year olds who are self-isolating at home - following government advice - need to be protected from fuel poverty and cold related illnesses. It’s Spring though right? This is whole days at a time & long range forecast: 'overnight frosts likely’ metoffice.gov.uk/weather/long-r… (10/17)

Fuel poor households are also more expensive to heat & home to more elderly people with pre-existing conditions.

More here --> assets.publishing.service.gov.uk/government/upl… (11/17)

Extending the warm home discount scheme (£140/household) may help protect the over 70 year olds following Government advice to self-isolate at home. (12/17)

Staying active in self-isolation is hard for all of us. Can our national broadcasters step in? Tailored home exercises for the >70 year old in self isolation? Maintaining strength reduces in hospital mortality and reduces #falls. @BBC @ITV @Channel4 (13/17)

Alcohol misuse is associated with accidents, injuries and violence – in Scotland minimum unit pricing had an immediate effect on alcohol purchases. We need to learn from each other and focus on works fast. @UK_AHA @scotgov @NicolaSturgeon (14/17)

Remember: we need to keep as much of our hospital capacity as possible for #COVID19 – these are extraordinary times, and extraordinary public health measures could help. (15/17)

So think:

What more can be done right now to protect people from #COVID19, protect the NHS and support our frontline staff? We must to be able to look back and know we tried everything we could. It’s the least we owe those working for us on the frontline & to one another (16/17)

We need bold and creative leadership to get us through this #COVID19 crisis – let’s pool ideas and draw on the evidence to #LowerTheBaseline and protect our vital #NHS services & frontline staff. (End)

Thanks @David_Simons_UK @OlgaPerski and @jamiebrown10 for your article highlighting this issue recently in (@bmj_company) BMJ Opinion. We need to incorporate all possible public health interventions to tackle the #COVIDー19 epidemic