More on vaccines. I'm going to get boring and geeky on this (no apologies) on the 10 year thing. Vaccines "normally take 10 years". This is being use as a reason to be fearful (ie rushed job). I'm a clinical trials doc. I can tell you most of that time is spent doing...1/n
.... nothing. It's spent submitting funding requests, then resubmitting them, then waiting, then submitting them somewhere else, then getting the money but the company changes it's mind or focus, then renegotiating then submitting ethics, then waiting for regulators...2/n
...then having problems with recruitment and having to open other sites, then dealing with more regulatory issues, then finally when you eventually get to the end of all of this you might have a therapy...3/n
... or not. At this point it may not be deemed profitable or any number of other obstacles.

However we have collectively now shown that with money no object, some clever and highly motivated people, an unlimited pool of altruistic volunteers and sensible regulators...4/n
That we can do amazing things (necessity being the mother etc). These trials have been nothing short of miraculous, revolutionary but in the context perhaps it is not surprising given our ability to innovate when we REALLY need to...5/n
and we really needed to. Safety hasn't been compromised. 100s of thousands of great people volunteered for experimental vaccines. The world watched closely. The press reported every serious adverse event. There have so far been a handful. A triumph of good people/good process.
I am confident that when regulators and scientists pour over the safety data (and we will because we are a bit that way inclined) that vaccines will only be used if we are confident that the risk is definitively outweighed by benefit. This should give you confidence too.

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More from @mark_toshner

Apr 2
🧵on why our current approach to covid is storing up problems, and one that isn’t being talked about.
Quick summary. Vaccines work, things are much better.
Otherwise we couldn’t have these levels of covid without breaking our ICU system
Read 23 tweets
Dec 5, 2021
Anybody want to discuss what we might do about the inevitable problems created by 2 years of pressure overload on hospital systems? A 🧵
I’m going to restrict myself to secondary care as I know it well (primary care others are better informed to talk about but goes without saying it is inter-related and needs viewed as a whole). I have many ideas but will talk about 2 of them.
In UK we are at system failure. This is really independent now of what happens next. Why? Because we are at historical levels of capacity breaching on every significant metric.
Read 22 tweets
Dec 3, 2021
As cases rise again above Oct (53,945), happy to rediscuss why I think people being too black/white in the pandemic is one of the major problems @andrew_lilico Image
Given your confidence seems misplaced on your only 6 weeks later and way before any Omicron wave if it happens, can you perhaps consider why people being definitive like this colours public debate? Image
Because at the time you were quite clear you don't think this is a problem. Image
Read 5 tweets
Nov 7, 2021
Do vaccines prevent transmission? A 🧵for donut lovers. Should be accessible to donut skeptics too.
First thing to outline is how the majority of the vaccine trials were set up. This was to measure direct infection. Some measured asymptomatic but most just measured symptomatic.
This is important because though effects are dramatic (and asymptomatic reduction strongly points to likely reduced transmission) it means initially we could not answer the direct question with direct evidence.
Read 19 tweets
Nov 5, 2021
What does a collapsing healthcare system look like in practice? 🧵
The first thing is- it will still function and see patients. It will have to prioritise, so anything non-urgent or life threatening goes first. Out-patients for chronic conditions, operations for anything that can be delayed etc.
With capacity breaching, efficiency drops off a cliff as much of time is diverted to simply trying to move people around and make room for ongoing emergency cases. Moving people around introduces obvious risk as mistakes harder to avoid when situation unstable.
Read 18 tweets
Sep 16, 2021
Wuhan long term data- This has been given a positive spin by the authors "Most COVID-19 survivors had a good physical and functional recovery during 1-year follow-up" 🧵 on why I think this is optimistic at best…
In this post-hospital cohort which always hits the journals first (for obvious reasons) and often patterns how we think of disease, far from being a reassuring demonstration of everybody getting better...
...half STILL have symptoms at 12 months.
Read 12 tweets

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