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19 Dec, 4 tweets, 2 min read
70% rise in transmissibility of #SARS_COV2 is really worrying

Sounds like enhanced Christmas restrictions are more than justified
Clear evidence of exponential spread in London and New Tier 4 areas

#SARSCoV2
This is good evidence of the increased transmissibility

#nvSARSCoV2
It makes the advice not to travel between areas a real imperative

We really need to take this virus much more seriously

#SARSCoV2

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More from @DrSimonAshworth

Simon Ashworth Profile picture
21 Dec
Had a phone call today to go and receive the Biontech/Pfizer vaccine at a GP Hub which had run out of patients to inoculate

We turned up at 30min notice were screened, ID checked, and vaccinated in 10min

THANK YOU to all those who contributed to this!
1/
It made me reflect on what a vindication COVID has been for science

The scientific method of observation, generating a hypothesis, testing the hypothesis and adapting has worked brilliantly, even if we are all pretty gloomy
2/
This would all have been impossible even a few years ago

The advances in molecular biology and DNA sequencing have been staggering…

And compare this to flu 1918, or the hundreds of years of Plague!
3/
Read 6 tweets
Simon Ashworth Profile picture
22 Nov
I am a senior doctor in Critical Care in one of the UK’s largest Trusts, so unhappily I have gained expertise in COVID, and humbly I say that there is much more pressure on hospitals, especially their ICUs
ICU/Critical Care is one of those specialities which is a fulcrum on which most hospitals depend

People who need major surgery often require ICU care as do those who suffer complications of cancer treatment, heart disease, trauma, infections, etc
The UK has a baseline of around 3500 staffed ICU beds, far below countries like Germany, Italy, and the US

They barely meet our needs at the best of times…
Read 16 tweets
Simon Ashworth Profile picture
9 Oct
If you have to ask, it’s disappointing.

But the answer is none of the staff who we need to care for critically ill patients have quite mastered the art of being in two places at once…
I realise my reply may seem facetious, so I will give more details. Initially COVID was presented as a simple disease and a bit of ventilation was all that was required. In fact it isn’t.
COVID is a multisystem disease that causes pneumonia skewed towards the highest severity of illness with terrible lung disease, kidney failure, brain involvement and very abnormal blood clotting. Some patients get poor cardiac function too. Treatment is rapidly evolving.
Read 9 tweets
Simon Ashworth Profile picture
8 Oct
Reckless with Hydroxychloroquine, there is a better chance Trump will be right that REGN-CoV2 will be of benefit. But we don’t know for sure and RCTs are essential

Not so sure millions of doses will be available that fast though…

And there is some observational evidence in #COVID19 for convalescent plasma, the active ingredient of which is mixed antibody

ncbi.nlm.nih.gov/pmc/articles/P…
And convalescent plasma appears safe - adverse events occurred in 1% of people given convalescent plasma (extracted from those recovering from COVID)

pubmed.ncbi.nlm.nih.gov/32525844/
Read 9 tweets
Simon Ashworth Profile picture
16 Aug
Really important paper. It proves that live virus can be cultured from air 2-5m from patients, and gets suspended in the air. This doesn’t mean social distancing is valueless, but it means it is not enough.

#COVID19

1/
medrxiv.org/content/10.110…
There are major implications for businesses returning to work in September:

1. Social distancing won’t be enough
2. Cloth masks won’t be enough - these particles are <1micron in diameter
3. Keeping the windows open is a good idea

2/
4. We will need to review standards for ventilation and air conditioning
5. Risks will depend on the prevalence of SARS-CoV2, footfall, and immunity…
6. Probably respires particles like these are the most dangerous because they get right into the alveoli of the lungs

3/
Read 4 tweets
Simon Ashworth Profile picture
19 Apr
@globalhlthtwit @Johnrashton47 @AllysonPollock @profhelenward @richardhorton1 @GabrielScally @devisridhar The situation is pretty obvious.

They lacked capacity, and lacked the imagination to go to big molecular labs for help, or to take on staff for proper contact tracing. Their plan was superficial and not calibrated for a more major or lethal pandemic.
@globalhlthtwit @Johnrashton47 @AllysonPollock @profhelenward @richardhorton1 @GabrielScally @devisridhar They were put on the back foot by Johnson who 3/2/20 said he thought it was trivial. There is a penchant for pseudoscience in govt, and an instinctive distrust of experts. Groupthink was inevitable.

There was a poverty of real data because 111 took a week to test
@globalhlthtwit @Johnrashton47 @AllysonPollock @profhelenward @richardhorton1 @GabrielScally @devisridhar People don’t realise expertise is quite subtle and fragile.

You either need a lot of courage or you need to feel very safe to stick your head above the parapet and say something unpopular. And in a pandemic the decisions are huge.
Read 4 tweets

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