THREAD: for anyone working with those or living with long term conditions whose care is being disrupted by Covid.

We asked parents of kids with Congenital Heart Disease (CHD) and adults living with CHD about their 1st wave experience...

Important lessons emerged! 1/6
Firstly, a lot depended on how well someone felt - people coping well with their CHD or those who were seen just before March lockdown were less worried. People with more complex disease were more likely to be worried and some had had no contact at all from specialists. 2/6
Many people spoke about getting different messages from different people - particularly about shielding and whether they shoud be at work / school.
People who had access to someone they could call for advice really valued it.
Some GP experiences were better than others... 3/6
For people who had treatment or check up postponed, the wait was very hard and very worrying. They felt that they were now responsible for managing a really complex and dangerous condition - the uncertainty of when things would change was also hard. 4/6
Services are now being suspended again. What can clinical services do better this time? Lots!
So much is about consistent and clear communication, having a phone number that people can call, reassurance that urgent problems would be dealt with.
Full recommendations in pic 5/6
You can read the full preprint here!
medrxiv.org/content/10.110…

Although this is about CHD, the recommendations are applicable to any specialised service for people who need regular check ups and treatments.

Please read and share! 7/7

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More from @chrischirp

16 Jan
THREAD: quick overview of where we are with Covid in the UK.

TLDR: some optimism but a long way to go. NHS will struggle for a bit yet :-( 1/11
First, cases have come down over last week which is good BUT they have climbed over this week.

Is this a blip? or is this is the impact of people going back to work after Xmas, more stuff open & more kids in school than March lockdown? This week should tell us more. 2/11
The proportion of people tested who have Covid is coming down in ALL nations - esp in NI and Wales. Good news!

BUT this misses data from later part of week which had higher case numbers & rates are still v high everywhere (we were at 1-2% over summer!) 3/11
Read 11 tweets
16 Jan
THREAD: on the connection between age, infection, hospitalisation, death and vaccination...

TLDR: it matters! so read 7 tweets :-)

Each bar in the charts shows the proportion of people in each of the coloured age categories. 1/7
Confirmed cases are more likely to be working age adults & older teenagers. Young kids (esp pre-school) less likely to show symptoms (& get tested) & poss less likely to get infected. Over 65s less likely to be exposed.

Vaccinating >70s is *not* going to stop Covid cases. 2/7
But although relatively few people over 65 get infected, they are the majority of people in *hospital* with Covid - they're much more likely to get really sick.

Vaccinating >70s WILL relieve a lot of pressure on hospitals (by March).

We still need to drive cases down NOW. 3/7
Read 9 tweets
11 Jan
THREAD: good news / bad news / good new on covid with data up to 5/6th Jan by date of test.

Thanks to Bob Hawkins who did the charts for me :-)
First, both Wales and N. Ireland now seeing sustained decreases in case positivity rates. Long may this continue.

Scotland is definitely flattenning and England looks like it is too. WIth any luck, both will start trending down over the next few days.
Looking at English regions, places that have been tier 4 equiv restrictions for longest (inc Christmas) are seeing little or no increase (SE, East, London). This is GOOD.

Bad news is that West Mids & NW saw big increase week after Christmas. Birmingham & Liverpool struggling.
Read 6 tweets
8 Jan
LONG THREAD: Digging into UK Covid numbers & what they mean & what's in store...

TLDR: everything is bad and getting worse.

Except vaccines. They are a shining light - we just need to give a LOT more of them.

Read on (25 tweets!)...
CASES: Cases are climbing very fast - over 735K cases in last 2 weeks, compared to 413K the 2 weeks before that. These increases *will* mean more hospital admissions and more deaths over the coming weeks.

I'm afraid that is inevitable. Image
Drops in testing over Christmas & New Year, and longer times to get tests mean that most recent 5 or 6 days is a bit unreliable.

Cases & +vity show massive increases in England & NI & also steep from Scotland. Wales is mixed. Don't trust v recent plateau - could be lag. ImageImage
Read 26 tweets
7 Jan
THREAD: Will lockdown work?

We're starting several weeks of lockdown in England while we try to vaccinate as many vulnerable people as possible.

Every day more stories drop about the terrible situation in hospitals.

The thing is, I'm not sure lockdown will be enough...
Last spring, we got R down to 0.6-0.7, cases & hospital admissions dropped steadily. Hospital occupancy peaked 3 weeks after lockdown. Even that will place unbearable strain on NHS.

But this isn't March's virus and this isn't (despite what govt is saying) March's lockdown. Image
Different virus: The new strain (B117) is estimated to increase R by between 0.4-0.7. Even a March lockdown will struggle then to bring R below 1 where B117 is widespread. Some regions might get lucky & stamp out B117 before it takes hold. With Xmas & NYE, seems unlikely.
Read 15 tweets
3 Jan
THREAD - Covid-19 in England.

Things are going from very bad to much worse.

Here is where we are in 9 tweets. 1/9
Cases: over *70,000* people who were tested in England on 29th December tested positive. This is *not* because there were more tests on that day.

It *is* 4 days after Christmas though, around when people who caught Covid on Christmas Day might start getting symptoms. 2/9 Image
The case data is very jumpy for the last week because of big drops in tests over Xmas and report lags. But the positivity rate from tests is shooting up - *everywhere*.

London has been in Tier 4 for 2 weeks.

Biggest worry: there is *no sign* that tier 4 is working. 3/9 Image
Read 9 tweets

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