@catchingthegos 90% of death certificates in which Covid is mentioned have it listed as Cause 1 a (the cause directly leading to death)

Certificates can only be completed by doctors who looked after the patient in the lead up to death and knew the full facts of the case
@catchingthegos we have a clear statutory professional duty to complete certificates to the best of our knowledge and beliefs

Falsifying certificates would be a serious offence with serious sanctions

certificates are checked by an independent medical examiner of deaths
@catchingthegos Even if we list Covid as cause 1b or 1 c or II we do not mention it if it did not play a part in the final illness and cause of death

Independent ONS data are collated from written on certificates and have absolutely nothing to do with government "within 28 day" definition
@catchingthegos If anything, it would seem the "within 28 days" definition *underestimates" the number of deaths from or with covid

Because some people die after weeks of illness (including long spells on ICU)
@catchingthegos There is no pressure of any kind from government agencies or acts of parliament for doctors to falsify death certificates or inflate death numbers

No incentive for us to do this (financial or otherwise)

No evidence that it is happening
@catchingthegos and you are talking to doctor with 31 years in the job, 10 months of solid Covid medicine experience and the RCP London elected officer who used to oversee the "learning from deaths" programme

The "Ego" i would be trying to "Catch" is your own. Have you ever certified a death?
@catchingthegos Perhaps if you had bothered to read the 800 word column (should take about 5 mins for an average reader) in which i explained all this (precisely to rebut this kind of nonsense) instead of reacting to the headline, strapline, pull-quote and something you had seen on a hashtag?

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More from @mancunianmedic

14 Jan
At least now grudgingly admitting that there IS a 2nd wave. The NHS had 100,000 staffing vacancies including 1 in 8 nursing and 1 in 11 medical and the fewest doctors, nurses and beds in the OECD *before* 2020. There is no magic staffing tree. It takes years to train people
and there are no extra staff to look after extra beds. The NHS has already (twice) doubled its ICU and HMU bed capacity (again, we went into the pandemic with among lowest per 100,000 in OECD) and repurposed swathes of inpatient beds. Glib rhetoric won't solve it @jamesmelville
meanwhile the staff who have gone well beyond for weeks on end at considerable personal risk of infection, admission, long covid or death (600 plus of us and counting) are not really helped by hostile opinion columnists with no training, experience or qualifications in healthcare
Read 5 tweets
12 Jan
Much of cabinet's handling of the pandemic (especially Matt-the-App also dubbed by @HPIAndyCowper as "the people's Partridge) has been an exercise in bragging with big meaningless (and undeliverable or plain wrong) numbers or flash gimmicks like Nightingales/Mass testing centres
it is a classical "boys and their toys" fixation.

People aren't that interested in how many pieces of PPE you have ordered or how many tests or jabs you are (over-promising) or how many Mass testing sites or exhibition halls filled with beds you can "deliver" "at pace"
what they are interested in is "can i personally or those close to me get the right PPE/a vaccine/a covid test/the test result"

It's a bit "Bread and Circuses" or "Distract them with a war" or a wall)
Read 4 tweets
30 Dec 20
hospitals inundated with patients who demonstrably, through clinical features we all recognise have Covid-19, beds occupied by them escalating fast, more on oxygen, ICU expanding capacity again and *still* people bloody blaming the PCR test.

Just, NO! PCR is *not* the problem
the number of PCR tests in community has not increased anywhere near as rapidly as the surges in clinical cases. And PCR false positive rate is actually low and sensitivity good in people with symptoms who we suspect are infected. Population screening of asymptomatic is different
meanwhile, false or first negatives are more of an issue in people with a high likelihood of infection for whom it soon becomes apparent that they do have covid clinical syndrome and then test positive
Read 13 tweets
29 Dec 20
I took these "empty& quiet" photos just now after seeing 28 covid patients on full ward in a hospital seeing 330 people each 24 h in A&E, expanded ICU & in a ward block with 11 adult medical wards CCU & ASU All pretty full. Shows how easy it is for denialists to cause mischief
the next thing would be "you are LYING. Those wards are not full Show us the data" (all in the public domain already) "the data are false" "the PCR is all false positives" "they all have a common cold" -

More predictable playbook than a Hallmark Christmas Movie

Denialist Bingo
if you wanna know what is in the vending machine it is of course self admin PCR and lateral flow tests with a false positive rate of 99.9% or false negative rate of 90% retailing at £2.20 and £1.70 from Young, Pearson and Delingpole PLC
Read 5 tweets
28 Dec 20
28 patients this morning All Covid-19 (as usual). 18 on Oxygen+Dex, 6 recently on it. 12 clear X-Ray changes 7 had GI upset (other causes excluded). 11-Diabetes. Only 4 on O2 had underlying resp disease

Most Covid cases in hospital not managed on ICU or HMU but acute wards
and most cases not managed in hospital but community settings with variable degrees of support/monitoring/self care.
the case mix we who have worked many winters in acute NHS hospitals are seeing and the clinical features of many patients do not in any way resemble a "normal flu season" or whatever other cliche people trot out who do not practice clinical medicine and never did
Read 4 tweets
27 Dec 20
@Bennett_C_ my view is that we men very much DO get impostor syndrome too (i would worry about anyone who didn't have it) - maybe not so often or so extreme. But my contribution is to say that there is a difference betweeen....
1. Men who really do think (delusionally or overconfidently) that they tick every box, meet every specification, have all the skills and are brilliant and can wing it on their wits (total lack of insight and realism)

2...Men who *do* have insight and self awareness and know perfectly well they don't have all the skills or experience ,know the need to rely on expertise from others and know they'll have a lot to learn on the job but say "I'll give it a go anyway and see if i can make a success"
Read 4 tweets

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