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17 Oct, 5 tweets, 2 min read
It's been a tough and rather disappointing week. On Sunday I wrote a short thread about the COVID-19 caseload during my day at work. This got picked up by someone with a very large following, triggering a tidal wave of hostile responses (many kind messages too). 1/5
.....as a result the tweet created extra work for colleagues so I deleted it and apologised. But my basic point that that we are dealing with a major problem in NHS hospitals was correct. It was disturbing to see so many people reject an objective report from the frontline. 2/5
With depressing predictability, the Number 10 briefings the next day showed things were even more serious than I had suggested, especially in hospitals in the north of England. Thoughts right now with colleagues having a tougher time than we are.
3/5
Can't help but think of Cassandra from Greek mythology who was cursed to utter true prophecies but never to be believed. Not to be confused with the 1976 disaster movie 'The Cassandra Crossing' about (no small sense of irony) averting a viral pandemic! en.wikipedia.org/wiki/Cassandra 4/5
But perhaps the words of George Santayana describe our situation best of all: Those who cannot remember the past are condemned to repeat it. We can control this virus but we need to learn from the past and take it seriously. Take care #HandsFaceSpace 😊en.wikipedia.org/wiki/George_Sa… 5/5

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More from @rupert_pearse

Rupert Pearse Profile picture
19 Oct
I'm going to discuss this with you, working on the assumption that you are a good person who is either poorly informed or has misunderstood the data. Please be respectful though (not everyone is).
1. There is a second wave but as the graph nicely shows, the rate of growth is much slower this time. Believe me, we are all very relieved about that. But a few ICUs eg Liverpool are already stretched to the limit.
2. I totally give credit to lockdown measures and #HandsFaceSpace for this. Tweet 6/6 in my thread makes that very clear and also our gratitude to everyone for working so hard to make that happen.
Read 8 tweets
Rupert Pearse Profile picture
18 Oct
Lots of discussion about improved survival in the latest @ICNARC report on COVID-19 admissions to intensive care published on Friday. But there's an even more crucial message in this graph showing the rate of increase in ICU admissions. 1/6 Image
We can now see that ICU admissions with COVID-19 are increasing at a much slower rate than March. So we are seeing a 'slow burn' rather than a 'second wave'. This could make the vital difference to how well @NHSuk copes through the winter. 2/6
This slower rise does NOT mean we will see fewer cases overall in the pandemic second phase. But it does mean we will see fewer cases AT ANY ONE TIME. NHS hospitals are like a flood wall: things are OK until the waters reach the top. But when they do we have a major crisis. 3/6
Read 8 tweets
Rupert Pearse Profile picture
17 Oct
Some optimistic commentary here from @FICMNews
Dean @AlisonPittard, suggesting we are getting better at treating COVID-19 leading to fewer deaths than the first wave. Is this over-optimistic, or are patient outcomes really getting better? 1/18
bbc.co.uk/news/health-54…
Importantly, @AlisonPittard is not just giving her opinion. Her comments are based on published data. For many years UK intensive care units have reported activity data to @ICNARC. During the pandemic, some of the most robust and objective data reports have come from them. 2/18
The latest @ICNARC report published yesterday describes outcomes for COVID-19 patients admitted to intensive care before and after 1st September. The report is available here: icnarc.org/Our-Audit/Audi… But remember this ONLY tells us about patients admitted to ICU (see later). 3/18
Read 18 tweets
Rupert Pearse Profile picture
10 Oct
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
Read 7 tweets
Rupert Pearse Profile picture
4 Oct
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
Read 15 tweets
Rupert Pearse Profile picture
4 Oct
Some interesting responses to this thread. Some further thoughts and clarifications.... 1/7
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
Read 7 tweets

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