Tweet

Tim Cook

4 Oct, 7 tweets, 4 min read

Important
At 0.7% this is about 3x the community rate
Depressingly familiar

Surge of Covid cases in London health workers sparks fear of spread on wards | Hospitals | The Guardian

amp.theguardian.com/society/2020/o…

We’ve seen it before

While the balance between allowing access to hospitals & preventing unknown Covid infected patients in is a tough one - it needs to be addressed to protect patients and staff

NICE NG179
Shortening self-isolation
nice.org.uk/guidance/ng179

&
PHE guidance downgrading in-hospital precautions for screened patients
assets.publishing.service.gov.uk/government/upl…

increase ease of access to hospitals for
-elective patients
-the SARSCoV-2 virus

Uncomfortable but needs addressing

for clarity although these figures relate to staff they illustrate hospitals as a potential source of outbreaks with asymptomatic staff posing risk to patients

COPE study showed concerning rates of infection of patients
- perhaps 1 in 4 of cases in hospital
- these patients did disproportionately badly (would expect much lower mortality in patients infected IN hospital to those admitted from severe COVID, but were the same)

...and of course CovidSurg tells us COVID and surgery don't mix

So staff infection risks harm to
-patients
-staff
-their families

• • •

Missing some Tweet in this thread? You can try to force a refresh

This Thread may be Removed Anytime!

Twitter may remove this content at anytime! Save it as PDF for later use!

More from @doctimcook

Tim Cook

@doctimcook

6 Oct

@BJAJournals

@BJAJournals @Paul_Barach @AirwayHub @AirwayInfo @AirwayMxAcademy @Milenio This is an interesting take.
To be clear, every harm or death of a healthcare worker from COVID is a tragedy

However despite anaesthetists/intensivists proximity to the airway it's far from clear that this raises risk of death compared to other HCWs
…-publications.onlinelibrary.wiley.com/doi/10.1111/an…

1/n

@BJAJournals

@BJAJournals @Paul_Barach @AirwayHub @AirwayInfo @AirwayMxAcademy @Milenio Rather than emphasising increased risk the editorial by @emirakur with @DrSimonLennane highlighted the international evidence showing lower than expected mortality among anaesthetists/intensivists and our co-workers
…-publications.onlinelibrary.wiley.com/doi/full/10.11…

2/n

@BJAJournals

@BJAJournals @Paul_Barach @AirwayHub @AirwayInfo @AirwayMxAcademy @Milenio @emirakur @DrSimonLennane Three analyses of HCW deaths were published in the @HSJnews

They're all here
hsj.co.uk/tim-cook/30082…

The notable findings were
- a marked excess of deaths in non-white frontline staff
- the absence of impact on anaesthesia/ICM

3/n

Read 12 tweets

Tim Cook

@doctimcook

11 Sep

As COVID19 rates start to increase this article might interest those who've not read it. Relevant well beyond anaesthetists and intensivists.

onlinelibrary.wiley.com/doi/10.1111/an…

Important to understand how risk changes as incidence does

@opensafely

Risk is of harm from COVID-19 is now informed by several mayor studies including @opensafely @ISARIC1 @ONS & @ICNARC

Read 17 tweets

Tim Cook

@doctimcook

21 Aug

PHE COVID infection control guidance updated today

You’ll likely love them or loathe them

gov.uk/government/pub…

High medium and low risk pathways created.

Elective surgical patients who have followed last weeks NICE guidance will enter the low risk path.

gov.uk/government/pub…

The NICE guidance means 14d self isolation is no longer routine. Rather isolation is to be from day of PCR test - which is to be up to 3d before admission

So routine isolation is max 3d but may be shorter

nice.org.uk/guidance/ng179…

Read 13 tweets