On call this weekend for @teamaccu@RoyalLondonHosp looking after our COVID patients in ICU. Reflecting on the new low that a small minority of doctors/scientists have reached in using their professional credentials to promote a bogus political agenda on public lockdown. 1/7
This very grandly named 'Great Barrington Declaration' is not, in my view, science or anything close to it. Once again we see doctors and scientists with low level leadership roles within our profession using their voice to pursue a political agenda. 2/7
This has happened repeatedly during the pandemic. Back in March I commented on the vast array of doctors and scientists writing letters and giving interviews on a subject far outside their fields. 3/7
This statement from the president of @acmedsci nicely explains explains the concerns that many doctors have with the over-reporting of this minority opinion within the scientific community: acmedsci.ac.uk/more/news/navi… 4/7
Medicine and science are extremely broad professions. Even within disciplines, individual fields are highly specialist. It's easy for doctors and scientists to misrepresent their expertise to project credibility for arguments which sound like science but are in fact politics. 5/7
Perhaps surprisingly, this doesn't often happen in normal times. But things have gone a bit crazy during the pandemic. A small minority of highly vocal doctors have repeatedly used their professional influence to promote political policies and minority scientific views 6/7
I am an expert in intensive care medicine. I can explain what I know, and will highlight the ideas of other experts who I trust. My private views will remain just that. I will never use my professional credentials to promote bogus ideas for personal gain. 7/7
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Someone asked if I could explain the various treatments which have been proposed for COVID-19. This is just my take and you may find some doctors disagree. Lots of research still ongoing - much of the world leading work is taking place in the UK funded by @NIHRresearch. 1/14
Hydroxychloroquine: Normally used to treat malaria and some types of arthritis. Was in early investigation in the Hong Kong SARS epidemic ten years ago. Huge hopes pinned on this drug but @NIHRresearch RECOVERY trial shows no benefit in COVID-19. Prevention trials ongoing. 2/14
Dexamethsone: A simple steroid drug widely used in many diseases. Shown in @NIHRresearch RECOVERY trial to improve survival for respiratory failure due to COVID-19 (i.e. severe cases only). Probably acts by reducing lung inflammation. 3/14
Engaging with people to discuss the situation reveals we all share lots of common ground, even when initial responses suggest otherwise. Accurate information can dispel anxiety even if it isn't the good news we hope for. 2/7
Lots of people (including many doctors) are really worried about NHS services for other medical conditions, not just COVID. You are absolutely right and we are working incredibly hard to make sure we keep all services going this time round. 3/7
Brief update from the front lines: The second wave is definitely here and NHS hospitals are putting the finishing touches to their escalation plans. Time to make the difficult call on how many COVID-19 patients to prepare for. 1/8
Shooting for a very large COVID capacity means planning to shut down some or all of our routine NHS work. Many doctors are concerned about protecting services for cancer, stroke, heart disease etc. 2/8
Plan A for a lot of hospitals will be preparing for a peak of around two thirds of the COVID numbers we saw in the spring. We can keep many routine services going at that level albeit at reduced capacity. 3/8
Finally got round to listening to this week's @BBCMoreOrLess. Some helpful explanation of govt stats on SARS CoV2 infection rates and false positives. Am reminded how slow I am to get my head around the statistics/maths of this. 1/5 bbc.co.uk/sounds/play/p0…
The fraction, percentage or rate of any test result is obviously dependent on which group of people you test. So random testing may yield a low rate of positive results but if you target your testing at people who think they may be positive, the rate goes up quite fast. 2/5
Sounds really obvious but it isn't. Several leading politicians and journalists are struggling with this fiddly bit of science and even the wonderful @d_spiegel got caught out trying to explain false positive rates to @JuliaHB1. 3/5
A reflection on the second wave so far. Last time we did what was asked with a huge sense of national community spirit. For each other. Because it was the right thing to do. This time we see much more use of 'rules' to make things happen, nationally and within organisations. 1/6
These new rules seem driven by the sense that some people are no longer doing what is right. They need to be brought into line, and quickly! Groups and individuals are being made examples of, sometimes unfairly. 2/6
We are all tired and rules don't go down well when we're tired. Especially if they aren't completely logical or we struggle to understand them. But most people are still doing the right thing, not to avoid getting into trouble but simply because it is right. 3/6
So this weekend, I decided to put a thread together which I hoped would reassure the patients served by my NHS Trust in east London. It seems to have caught the mood. Some reflections. A thread on a thread...
As I write this, yesterdays thread has close to 1 million impressions. Other metrics equally extraordinary and roughly 2500 people have followed me in less than 24 hours. Which is a lot for me! It makes me think that many people are finding simple objective facts hard to come by.
I have been humbled by the number of kind messages and thanks for what the NHS is doing. I am so grateful but I, and most others I know, consider it a privilege to care for you as our patients. We aren't heroes - we really are just doing our job.