Mark Toshner Profile picture
Nov 17, 2020 7 tweets 2 min read Read on X
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

Sep 24, 2023
🧵on PAs in UK NHS. Bit of both-sideism but from a skeptic viewpoint. Strap in. This will not be short!
Starting point- can some of clinicians work be done by others? Simple answer is yes. Our jobs can be discretely broken into domains (pick your own schema)
- admin
- clinical assessment + treatment
- procedural
- leadership
- teaching
- holding risk
The list goes on
A quality trained doctor does all of this but no reason bits can’t be broken up and done by others or amalgamated with new roles. In fact it happens all the time & without controversy. So why the brouhaha over PAs?
Read 43 tweets
Aug 16, 2023
Are you sitting on Twitter wondering why doctors are on one hand complaining about being understaffed & simultaneously incandescent with rage about mushrooming non-doctor roles? 🧵 for you.
We will start off with the simple bit we can all agree on. There are not enough healthcare workers (in any part of the system, not just doctors). UK Workforce plan is clear on this and everybody agrees. ……
This is btw a global and not local problem which means usual developed world plan to just asset strip human resources from elsewhere is harder,…
Read 19 tweets
Jun 27, 2023
If you want to understand why doctors strikes will not end any time soon and why this is a disaster, take the temp of doctors from contemporary surveys 🧵
First up GMC. Absolute historic levels of every flashing red light possible, from doctors taking steps to leave, through concern over ability to give safe care to burnout levels.
RCP survey is also consistent with this and workload a major concern in both surveys.
Read 12 tweets
Sep 1, 2022
I’m just having so much fun this am imagining the reviewer 2 comments that led to this being rejected by Science & moved on to Science Advances…
The work lacks novelty. Trees have been doing this for millennia.
As an n of 1, I insist on it being replicated on 2 more planets.
Read 5 tweets
Apr 2, 2022
🧵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

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