THREAD ON FLU:
Just an attempt to start a conversation about annual flu.

I'm not an expert on this at all and welcome people's thoughts and insights...

Basic question is: how many annual flu deaths are acceptable? 1/7
In a "normal" year there might be c. 10,000 deaths from flu in England & Wales, mostly in people over 65.(greenwichccg.nhs.uk/News-Publicati…),

Timing & number varies depending on flu strain, how good that year's vaccine is & vaccine uptake.

Flu is also LESS infectious than Covid. 2/7
And the measures that work against Covid, work against Flu -> so this year we've seen HARDLY ANY flu.

The chart below compares English hospital flu admissions - but same picture for GP swabs, 111 calls etc.

Same across Europe (flunewseurope.org) 3/7
So... this means that presumably we could, if we chose, prevent a majority of the 10K annual flu deaths with the sorts of things we've done for Covid.

Most people would say the cost (lockdowns/social distancing) is too high. I agree. But is there a middle ground?? 4/7
Should we just go back to normal entirely & accept 10K deaths a year?

Or should we try to prevent some by e.g. wearing masks in shops & public transport Oct - Feb, making hand sanitiser available in every shop/train station/workplace, not going to work with flu symtpoms etc 5/7
I don't know how much impact these things would have on flu transmission.

I don't know if it could make things worse by making us all more susceptible to a big flu pandemic when it comes.

There are 100s other things I've not thought of. 6/7
I just think that we should be thinking about it at some point.

Can some simple preventative measures make flu less deadly every year? (and some of the annual winter NHS pressure).

What measures are acceptable? If the answer is "none" - then why is that ok? 7/7

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More from @chrischirp

29 Jan
SHORT THREAD ON SCHOOLS:
When schools go back is a tricky issue. I'm not going to get into it here BUT wanted to highlight a couple of data points from PHE surveillance & ONS infection survey this week. 1/5
Firstly, since early Jan, there have been a number of outbreaks at nurseries (open) & special need schools (30% attendance) (and yes - Covid).

A few at primary schools (20% attendance) and v few at 2nd-ary schools (5% attendance). 2/5
Added to that among young school age kids, case rates going down for primary school ages but UP in pre-school and nursery age children.

Secondary school age going down (not shown). 3/5
Read 5 tweets
29 Jan
MINI THREAD ON HOSPITALISATIONS:

The number of people in hospital with Covid is either flat or coming down in all 4 nations - excellent and a sign that infections really are going down (at least in older groups).

BUT they are still higher than April peak everywhere 1/4
In England, hospital admissions are now coming steadily down from 12th Jan peak and are now below the April peak too... good! 2/4
This is true for all regions of England (good!). You can see that they started going down in previous tier 4 regions (London, SE, EoE) about 7-10 days earlier than other regions. 3/4
Read 4 tweets
26 Jan
Giving some examples on @BBCOne @BBCNews just now about why we we could have - and should have - avoided more than100,000 people dying from Covid.
Other missed opportunities: not making workplaces safer (e.g. DVLA, Sainsbury outbreak, high care worker deaths), not making schools safer, not anticipating uni surges in autumn, etc...
But I did say, and do believe, that the vaccination programme is going very well. So let's acknowledge that at least.
Read 4 tweets
20 Jan
THREAD: we need start planning for the recovery of NHS staff right now.

NHS staff are working beyond their limits – have been for weeks and will continue to for weeks. They've been at the limit for a year. What will be the consequences? What can be done?

Please do read. 1/12
NHS workers are already at higher risk of mental health problems & suicide than general population. Studies pre- pandemic showed that UK nurses & docs were 2-5 times more likely to take their own lives than the general pop.
metro.co.uk/2018/09/03/sui…
independentnurse.co.uk/professional-a… 2/12
The British Medical Association did a survey after the 1st covid wave. 45% of ICU staff showed signs of mental ill-health, 40% with signs of PTSD, more than 2x recent combat veterans. 1 in 5 nurses & 1 in 7 docs had thoughts of self-harm or suicide.
bmj.com/content/372/bm… 3/12
Read 14 tweets
17 Jan
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
Read 6 tweets
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

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