Andrew Lee Profile picture
Aug 13, 2020 4 tweets 1 min read Read on X
Early results from PRIEST Study - a multicenter observational cohort study of patients attending UK Emergency Departments.

Profile of ED attenders here:
medrxiv.org/content/10.110…

@ScHARRSheffield
1/...
Adults attending ED with suspected COVID-19 had substantial co-morbidities.

Men more likely to be admitted, have positive COVID-19 testing, require organ support & die.

Reassuringly, children had much lower rates
of admission, COVID-19 positivity, organ support & death .

2/...
Black or Asian adults attending ED tended to be younger than White adults, less likely to have impaired performance status, be admitted to hospital or die, but more likely to require organ support or have a positive COVID-19 test. Comorbidities varied between ethnic groups.
3/..
These findings suggest a complex interaction between underlying demographics and comorbidities, susceptibility to COVID-19 and use of health services may explain differences between ethnic groups.

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More from @andrewleedr

Sep 22, 2022
The NHS has an abusive relationship with its workforce. Under the guise of "professionalism" & "vocation", many staff are expected to work long hours, often antisocial ones (nights/weekends/bank hols), & work over & above their contracted hours. Staff feel guilty if they don't...
...do the hours. You're shirking/slacking, letting down your patients/colleagues, it's unprofessional, etc.
We select them young (on the basis of them being caring, having a vocation), & indoctrinate them at medical/nursing school, perpetuating this abusive relationship...
The staff (especially medical) take on a lot of risk - anything goes wrong & it's on your head.
Yet they turn up to work with this illusory idea of vocation/professionalism & promise of public respect.
They may sacrifice marriages, family time, personal health/wellbeing, etc...
Read 11 tweets
May 3, 2022
The NHS is under tremendous strain at the moment, & this is occurring across many sectors - primary care, ambulance services, acute hospital care, mental health & community care. The huge demand for care outstrips what the system can currently supply.
1/
hsj.co.uk/quality-and-pe…
This has consequences.
Longer waiting lists, reduced patient access, delayed investigations & treatments, all of which will impact on the experience of care as well as health outcomes.
2/
Some services have been for many years much worse off compared to others, usually community-based services & mental health services, or primary care until recently but not enough to offset years of under-resourcing.
3/
Read 15 tweets
Mar 14, 2022
Operational public health considerations for the prevention and control of infectious diseases in the context of Russia’s aggression towards Ukraine.
Informative @ECDC_EU guidance particularly relevant to refugee health issues
1/
ecdc.europa.eu/en/publication…
Ukrainian refugees may be at risk of certain infectious diseases.
Key ones to watch out for for kids are measles & polio, due to insufficient vaccine coverage (82% & 80% respectively).
Crowded bomb shelters & reception centres can facilitate spread.
businessinsider.com/video-ukraine-…
2/
Ukraine was experiencing its largest COVID-19 epidemic wave just before the war. The precipitous drop you see in the figure below will probably be due to disruption of testing & reporting.
Vaccine coverage low ~35% across all age groups so an under-protected population.
3/
Read 8 tweets
Mar 11, 2022
Effectiveness of 2-Dose BNT162b2 (Pfizer BioNTech) mRNA Vaccine ... cdc.gov/mmwr/volumes/7… via @CDCgov
PROTECT is a prospective cohort study monitoring SARS-CoV-2 infections in participants aged 6 months–17 years in Arizona, Florida, Texas, & Utah. The kids were tested for SARS-CoV-2 weekly from July 2021–February 2022 & had various data collected monthly.
2/
Around half (51%) of all Omicron infections were asymptomatic compared with approximately one third (34%) of Delta infections.
3/
Read 9 tweets
Jan 13, 2022
Self-isolation period for people infected with COVID in England will be reduced to 5 days from Monday 17 Jan. But it's conditional: 2 NEGATIVE tests on days 5 & 6, & no symptoms, & not in certain high risk situations e.g. working with vulnerable people
1/
gov.uk/government/new…
I understand the desire to reduce the isolation period to minimize the impact on the workforce, the economy, strained businesses/NHS & people's lives.
But, this is not a risk-free approach and I'm concerned...
2/
With a shorter isolation duration, you increase the chances of releasing someone who may still be infectious back into the community. This risk is ~1% at 14 days, 5% at 10 days or 7 days with 2 negative LFDs, or 10-30% at 6 days after symptom onset.
3/
ukhsa.blog.gov.uk/2022/01/01/usi…
Read 14 tweets
Jan 11, 2022
🇨🇭 preprint study comparing RNA & infectious viral load between pre-VOC strains & Delta VOC in unvaccinated patients as well as in vaccination breakthru' infections due to Delta and Omicron.
Useful study as virus culture may be a better proxy for infectiousness.
1/
Findings:
🔹Low correlation between RNA genome copies & infectious viral titres.
🔹No correlation between infectious viral load & age & sex of patients
🔹Unvaccinated patients infected with Delta have higher infectious viral load

2/
🔹Vaccinated patients had lower infectious viral load than unvaccinated patients.👉Vaccination makes you less infectious.
🔹At 5 days post symptom onset, detected infectious virus in 54% vaccinated & 85% of unvaccinated patients (so beware shortening isolation duration!)
3/ Image
Read 4 tweets

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