26/42 Are there any national datasets that accurately capture what is going on? The brilliant @jburnmurdoch has highlighted number of admissions into ICU. The message from his animated chart (click on link) couldn’t be clearer – this winter is v unusual: .
27/42 Some sceptics arguing covid-19 tests are inaccurate. PCR tests not 100% accurate but hospital inpatient testing accuracy much increased by frequency of testing (typically admission, days 3 & 6/7, then weekly). This means very low numbers of overall false positives.
28/42 Some sceptics argue that the published covid-19 positive inpatient numbers include both those admitted with covid-19 and those who acquired covid-19 in hospital. And that there are significant numbers of patients who have acquired covid-19 in hospital.
29/42 Covid-19 positive test data has always included anyone testing positive, irrespective of initial diagnosis. And the NHS has always acknowledged that hospital acquired (nosocomial) infection is a big issue. Hospitals are working incredibly hard to control it….
30/42 …The NHS regularly and completely transparently publishes nosocomial infection data, by hospital. But neither issue affects the degree of pressure that hospitals are under. Every inpatient, irrespective of initial diagnosis/infection source, occupies a hospital bed.
31/42 Some sceptics using regular @ONS & @PHE_uk mortality data to argue that current death rates are just reflecting ordinary mortality rates for this time of year. Or that the covid-19 mortality definition and diagnoses are mixing up ordinary respiratory illness and covid-19.
32/42 This excellent thread looks at these issues in detail. It shows clearly why it is too early for the current sets of this data to be showing increased levels of mortality from the current, new variant driven, surge of covid-19 infection.
33/42 In the words of this thread: “If you are using the ONS + PHE data to assess excess deaths that are happening *now* you are using the wrong data because of lags. The impact of this surge will only become apparent in future data from the ONS + PHE”.
34/42 The current covid-19 death definition widely accepted across medical profession. Doctors are required by law to complete death certificate to the best of their knowledge and ability. Covid deaths are running at an alarming rate – currently over 1,000 a day.
35/42 Some sceptics are arguing that the failure to use Nightingales before now indicates that the NHS isn’t that busy. They are not purpose built hospitals and would require staff to be transferred from other settings. Systematic use was always a last resort insurance policy…
36/42 …The NHS was always going to use every ounce of permanent purpose built capacity first. The fact that the London Nightingale is opening next week is a sign of how pressured the NHS in London has become. Other Nightingales – e.g. Exeter and Manchester – already in use.
37/42 Particularly loathsome are the videos of empty corridors and hospital areas. There are lots of good reasons why some areas of hospitals will be much quieter than usual. No visitors due to infection control. Outpatient clinics moved online. Films being done at night-time…
38/42 …Waiting areas not in use due to social distancing. Reduced levels of ordinary planned surgery. Most activity and staff in hospitals will currently will be concentrated on covid, intensive care and emergency areas. Areas where illegal filmers can’t film.
39/42 And, as this thread from @dpjhodges - - argues. If the sceptics are right, those charged with nation’s health – CMO, CSA, Ministers, officials, NHS leaders – all have to be unaware of the data problems sceptics have "identified"...
40/42 …And despite their decades of cumulative experience, they are making major public health decisions totally oblivious to the catastrophic misreading of the data that the amateur lock-down sceptic sleuths have uncovered…
41/42 ...or they are unaware of these catastrophic misreadings. And, for reasons no one has yet rationally explained, they are all carrying on regardless, day after day, month after month, perpetuating one of the greatest public health hoaxes in history.
42/42 Worth adding that the more evidence & data driven sceptics now abandoning sceptical camp: spectator.co.uk/article/lockdo…. Still time for rest to follow! Particularly since everyone in NHS from frontline staff and trust leaders to @NHSEngland CEO is heartily fed up of this cr*p.

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More from @ChrisCEOHopson

10 Jan
1/42 Good to see yesterday’s @thetimes editorial attacking the pandemic of covid misinformation. Here’s my twitter contribution to fighting it, as suggested. Lockdown and covid sceptics continue to consistently misuse cherry picked data to argue NHS not unusually busy.
2/42 NHS trust leaders believe this disinformation is profoundly disrespectful to staff and risks reducing vital compliance with restrictions on social contact. Below is a long two part thread answering the main "NHS not unusually busy" and other NHS related disinformation.
3/42 Much of the disinformation comes from simplistic year on year percentage comparisons of data. Some types of NHS demand are flat or lower year on year. But it’s a huge distortion to argue that these individual statistics mean the NHS is not unusually busy.
Read 25 tweets
4 Jan
1/8 Speaking to NHS trust leaders across country and looking at today’s statistics on beds occupied by COVID patients, it's clear we have now reached a critical point. Immediate decisive action is now needed to stem rapidly rising rate of infections, hospital admissions & deaths Image
2/8 Trust leaders are clear about cost & impact of tighter restrictions. But, to prevent significant numbers of unnecessary deaths, reduce patient harm and give NHS best chance of treating all patients who need care, Govt must now immediately tighten current tier system rules.
3/8 Government will announce its new plans this evening. NHS trust leaders are insistent that any tightening should be immediate and decisive. Current tier 3 rules are insufficient and tier 4 rules appear to just slow down the rate of increase in Covid transmission, not cut it.
Read 8 tweets
2 Jan
23/31 WHAT HAPPENS NEXT? Speed at which covid transmission & hospital admissions slow down is key. Some evidence that increases in rate of infection starting to slow in parts of London/SE. Current best guess suggests peak NHS covid demand might be 2nd/3rd week January?
24/31 Trust leaders also worried that usual early January demand spike now imminent and wider cold weather will mean more emergency demand and staff absence. On plus side, infection control measures mean low winter flu levels and, at moment, low levels of norovirus and D&V bugs.
25/31 The next two to three weeks are therefore critical. How much more capacity will London/SE need before the peak of demand is reached? How best to support trusts in North and Midlands if they start experiencing the scale of increase in covid cases recently seen in London/SE?
Read 9 tweets
2 Jan
1/31 Lots of media coverage, rightly, on huge NHS pressure. What’s cause of, and how widespread, is pressure? How is NHS responding? How serious is this & what’s impact on patients & staff? What’s likely to happen over next few weeks? Long new explainer thread below in two parts.
2/31 WHAT'S CAUSE OF, AND HOW WIDESPREAD IS, CURRENT NHS PRESSURE? Remember overall context. Winter always busiest time of NHS year & NHS capacity always at its most stretched. Last five winters show that, despite increases in capacity, NHS at / over its capacity limit...
3/31 ...Whilst overall staff levels improved in 2020, NHS also entered year with 100k vacancies. Covid makes all this much worse. NHS balancing four sets of patients – winter patients; covid patients; planned care cases, incl. delays from first phase; and those needing vaccine.
Read 23 tweets
16 Dec 20
1/10 What should happen next with the tiered restrictions and the proposed Christmas relaxation? Our new media statement just issued. Full statement is attached and new twitter thread of the key messages is set out below.
2/10 Having spoken to a number of our NHS trust members over the last 48 hours, three things are crystal clear. First, there is a ring of areas around London – for example, in the Home Counties – where trusts are alarmed at the rise in infection rates and hospital admissions....
3/10 ...The Government has rightly put London and parts of Essex and Hertfordshire into tier 3 earlier this week. It must now urgently consider adding other areas to that tier where infection rates are similarly worrying. Speed is of the essence here.
Read 11 tweets
15 Dec 20
1/17 Very technical thread for those interested in detail of NHS finances. We've been discussing how to move to more system focussed finances in 2021/22 with members and @NHSEngland. We've turned that work into the following asks: nhsproviders.org/media/690684/f…. Asks in thread below.
2/17 If funding flows change before ICSs are put on a statutory footing, @NHSEngland must clearly set out the legal underpinning for how funds will flow to and within ICSs. Including how this will align with the formal responsibilities of accounting officers & trust boards.
3/17 @NHSEngland must publish its full methodology for determining the size of each ICS funding envelope. This should account for how each constituent element is calculated, including the logic behind any provider level allocations so this is fully visible to all within the ICS.
Read 17 tweets

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