Thread by @uberrimaefidei1

@afneil The focus on ventilators is about as useful as focusing on whether we have enough coffins. There are more valuable interventions that are being totally ignored in uk at present. Let's run through them:

@afneil 1. Early intervention at home for ALL who develop mild #COVIDー19 symptoms - give them ALL a 5 day course of #chloroquine or #Hydroxychloroquine - this will prevent vast majority of severe cases needing to anywhere near a hospital

@afneil 2. Give PEP - post exposure prophylaxis of #chloroquine or #Hydroxychloroquine to the household members in a home where a person develops symptoms. Evidence is that most transmission is within the household. So stop the virus there!

@afneil 3. Mandate use of masks outside the home - easy for police to enforce. This is a respiratory pathogen it spreads via aerosols over a substantial distance. Doesn't need to be N95 mask, surgical mask or even a scarf helps. It's about viral particles NOT getting out of your airways

@afneil 4. Get antibody testing out at scale in the home. A system that allows people to prove they have had the virus and are immune with a visible token that they can wear to prove this. We can then get a semi-normal society operating again and minimise the economic carnage

@afneil 5. Forget about PCR testing for active viral infections. It's too slow. Instead use #POCUSforCOVID #POCUS . The ultrasound presentation of #COVID19 is easily recognisable and lung symptoms apparently present in mild / asymptomatic cases. #POCUS is cheap / easy to train Dr's on

@afneil 6. For anyone who ends up in hospital. Aggressively treat early with combination of the available drugs #chloroquine or #Hydroxychloroquine plus #Azithromycin plus #kaletra and potentially early use of an IL6 inhibitor.

@afneil 7. Goal being to avoid intubation / ventilation which has a generally poor prognosis in #COVIDー19 cases. There seems to be an emerging case for trying whole blood transfusions on patients being admitted to hospital given possible viral damage to RBC's causing hypoxia

@afneil 8. We should have a mass programme in place to harvest convalescent plasma from antibody positive people. There is no doubt that this plasma saves lives from #COVIDー19 if we have it accessible in volume it can become an early intervention on hospital admission and

@afneil As a massive morale booster for the population would be invaluable. You could literally save a life by giving blood.

@afneil 9. Need to up our PPE game for frontline medical staff. Antibody test all frontline medics fast. Antibody positives need minimal PPE - they're immune. Focus serious PPE for medical staff not yet infected to minimise their risk - this will reduce shortages and raise morale

@afneil 10. I could come up with many more suggestions. None of this is rocket science. Why government and their army of experts aren't doing this stuff is beyond me but we're well into the field of incompetence and neglect here by HMG. UK citizens need to know this #coronavirusuk

@afneil @threadreaderapp unroll please