At current growth, covid hospital admissions in North of England less than a week away from levels London had on lockdown day in March (per population)
Covid loves us socialising indoors (pubs & homes) and laughing, chatting over a table for hours... I think right now closing indoor pub service in hard hit areas & restricting household mixing is right thing to do BUT we need to work immediately on plan to reopen inc
Fixing test & trace (e.g. in England, currently works least well where needed most). This inc supporting isolation - financially (£500/2 wks less than minimum wage!), practically (caring responsibilities, grocery, accommodation...) (govt SAGE said same bit.ly/2SBpfKP
Launching a big effort to improve ventilation in homes (particularly poor quality housing) *and* pubs, bars, restaurants, schools & uni accommodation - with funding! Inc better regulation of businesses.
clear, regular communication. UK govt needs to start daily press briefings again - why haven't they? things changing so quickly we need these back! and to hear a clear strategy for getting *out* of restrictions (getting out of restrictions is v possible!)
We need all of it (& all of us) to work together - restrictions without support & targeted improvements (eg housing, ventilation etc) will do little. We need generous support for hospitality industry while we get cases down - god knows, we're going to need a drink when it's over.
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THREAD: many of us in healthcare have seen new IT systems hailed as gamechangers. Many don't live up to their promise. Often failure is at final step of implementation - I interviewed people at 4 hospitals who all implemented the same IT system & developed these cartoons...
The hope is that they capture typical stories of what pitfalls happen in real life - and gives tips for how to avoid them! The full cartoons (and a downloadable booklet) are freely available from @nejmcatalystcatalyst.nejm.org/doi/full/10.10… but here are some with real quotes :-)
"Because it involved IT, even tho the CMO had signed off & we had his blessing & the promised resources & the contract, then we had to go through what we call the IT gov committee. Which is not a quick process, so we had to formally present this…and that took another 6 mnths"
SHORT THREAD: Some interesting (if unsurprising) data in NHS test and trace this week on age profile & positivity rates - particularly for kids & young adults. 1/4
Firstly, MASSIVE increase in school-age kids getting tests in September. Stark to see how much extra capacity was needed - not surprising and should have been anticipated! Also surprising that 20-29 yr olds NOT getting more tests even though age group with most infections. 2/4
BUT, no increase in cases among under 10s and only modest increase in 10-19s. Biggest increase in cases by among 20-29 years olds. This age group should really be getting more tests. 3/4
THREAD: what happened with COVID in September and where are we now? It's been an eventful month and there is good news and bad news... read on to find out which is which!
NB: Longish thread (18 tweets) but hopefully informative with lots of pretty charts...
Confirmed cases have continued to rise, but hard to interpret cos of ongoing problems with testing. But let's go with this for now - where are the confirmed cases?
All the nations have seen steep increases over September but Wales and N Ireland doing rising less steeply than England and Scotland... Let's dig a bit further into England
THREAD: as requested by absolutely noone here are some thoughts on COVID-19, the UK and exponential growth... (it's a positive thread though!) 1/11
Infectious diseases by their nature have exponential growth while lots of susceptible people are around (still case in UK) as each person infects others. Left to its own devices, COVID-19 cases would double every 4 days or so. With knock on increases for hospital admissions 2/11
But we've not left COVID-19 to its own devices. We've done lots of things to slow the spread (social distancing, masks, rule of 6 etc). This slows down the *doubling time* (how long it takes for cases to double) - effectively giving us longer to bring down transmission. 3/11
THREAD: The latest @PHE_uk weekly surveillance report makes for sobering reading - here are some key things that have not yet been widely reported - inc care homes & inequality. Please read and share! (whole report: assets.publishing.service.gov.uk/government/upl…) 1/9
Linked tweet shows that increases have been mainly in 20-29 & 30-39 ages but spreading to older groups.
BUT this shows that it's spreading most in most deprived areas - where people are in poorly paid work & housing & can't afford to isolate. 2/9
Meanwhile this graph shows *again* that those seriously ill with COVID (needing ICU) are disproportionately from BME communities. COVID loves inequality. 3/9
THREAD: where we are with COVID in the UK and what we should do about it. TLDR: it's not good, but there's hope. We have maybe 2/3 weeks to get cases down. 1/13
Firstly, testing & tracing is in crisis as has been well documented for the last two weeks. Only 9% of tests in England are now returned promptly. 2/13
So we have to take recent case data with a pinch of salt - we know that many aren't getting tests. We know that there are big backlogs. We don't know exactly who is getting tested. But *even so* cases are climbing rapidly. 3/13