I seem to have been saying this internally within @PHE_uk and predecessor organisations forever.

Every time there's a major event and they ask for feedback, we tell them "Email does not work. It gets /we get overwhelmed. We can't keep up and feel guilty. It's stressful."
1/6
We frequently get the same message once from the original sender, and then four more times from people concerned we might have missed it; and then we have to try to work out if we're looking at an updated version...
2/6
And sometimes the delays mean that we receive older versions after newer ones... It is a disaster!
3/6
We still continue to get huge numbers of pieces of guidance by email. Each one of us then has to find a way to save the information where we'll be able to find it again…
4/6
(…or give up and live with the stress of knowing that we might be working to the wrong guidance, in ignorance of the existence of the correct guidance).

Covid-9 has exacerbated these problems.
5/6
I have views on specifically how we can do this better. But PHE is a KNOWLEDGE organisation, that should be proud of its knowledge management systems. Instead, they are non-existent or could be improved by updating them to 1980s technology. It is shameful.
6/6

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More from @petermbenglish

30 Nov
We keep banging on about "test and trace" for #Covid-19.

But it's pointless.

With a reproduction interval of only 4-6 days, if you wait for a test result before isolating contacts, you will do it too late. They will already have spread the infection.
1/2
And many cases are asymptomatic, so you'll miss them, anyway.

Testing is too unreliable. Too many false negatives, and too short a time from infection to infectiousness.

The only thing which works is keeping people apart so they can't transmit it.
2/2
"given the
potential delays in isolation of patients, even the early
detection and isolation strategy might not be fully effective
in containing SARS-CoV-2."

thelancet.com/journals/lanmi…

@mugecevik et al
Read 4 tweets
30 Nov
Hi @ajpollard1 @OxfordVacGroup !

What does "ChAdOx1 vector is modified to be replication deficient" mean?

Can it induce production of antigen proteins if it doesn't replicate at all?

Does the lack of replication reduce the immune response to the vector?
1/3
Are ChAdOx1 vector vaccines contraindicated where live virus vaccines are contraindicated (and why [not]?)

Where can we find a New Scientist level explanation of these things?
2/3
If it is "replication deficient", how do you produce it? Can you culture it?

Parenthetic thought:
Are viruses ever "live", and where does this vector vaccine fit? Is it a Schrödinger's virus, alive or dead, depending on your reason for asking?
3/3
Read 4 tweets
27 Nov
Editor of @bmj_latest @KamranAbbasi on Facebook (& the Danish mask study):

"A disagreement among experts, especially about interpretation of a study, is a common occurrence. It is the usual business of science. Only, Facebook didn’t see it that way…
bmj.com/content/371/bm…
1/7
"The social media platform that allows statements about injecting bleach to prevent covid-19, [and] calls to behead the leading US expert on pandemics, decreed… Heneghan & Jefferson should be censured for misinformation after they reposted their Spectator article on [FB]…
2/7
"It is possible to disagree with Heneghan and Jefferson about the robustness and interpretation of the DANMASK-19 trial—which I do—and still believe it is wrong that their opinion of it was marked as “false information.”…
3/7
Read 7 tweets
27 Nov
Editor of @bmj_latest @KamranAbbasi on PHE:

"PHE is no more after 7 years of controversy.

bmj.com/content/371/bm…
1/4
"…Its proximity to government and industry, together with funding cuts to local authorities, essentially set it up to fail and now to become the government’s fall guy for a flawed pandemic response…
2/4
"…PHE is being replaced by a national institute for health protection, which may well be closer still to government and industry…
3/4
Read 4 tweets
27 Nov
CCGs to be replaced as commissioners by ICSs, under NHS England proposals pulsetoday.co.uk/news/nhs-struc…
@jkaffash @costanza_fierce
The wheel continues to rotate…
1/8
They keep creating bodies in which trusted GPs are the commissioners; and they keep ensuring that they fail and revert to being something like a 1980s Health Authority...

I wrote about this in BMJ 10 years ago. bmj.com/content/340/bm…

2/8
"Politicians realise that people trust their general practitioners more than politicians or faceless commissioners in the health authority, primary care trust, or whatever the organisation is called at the time…
3/8
Read 9 tweets
15 Nov
I despair. Look at nhs.uk/conditions/cor…

"You may want to tell people you've been in close contact with in the past 48 hours that you might have coronavirus."

You absolutely MUST do so, immediately…
1/
"[Your contacts] do not need to self-isolate unless they're contacted by the NHS Test and Trace service".

Which will only happen after they've infected most of the people they could've; and too late to have much effect.
2/
We will never get on top of this pandemic like this. To work, TTIS (test, trace, isolate, support) will never work unless contacts isolate immediately.
3/
Read 8 tweets

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