Paul Nuki Profile picture
10 Mar, 5 tweets, 2 min read
1/5 I find the debate over aerosol transmission very odd. It's perfectly clear respiratory viruses spread that way in part at least, and has been for years. It raises some important questions for Western science ...

ncbi.nlm.nih.gov/pmc/articles/P…
2/ First, why the reluctance to accept what is so clearly evidenced? My guess is that like so much necessary but avoided pandemic planning, it's all about resources and long established (but incorrect) professional group think ...
3/ If you accept respiratory viruses can spread via aerosols, you need to rethink the design of countless systems, buildings and public health protocols. It's a huge job which disrupts everything. It's therefore one we would prefer to avoid, or "park" in the language of PHE...
4/ Western science may also, in retrospect, be seen to have a very particular bias arising from the fight against the big infectious killers of the 19th and 20th centuries, most of them water borne. "We didn't struggle against all that miasma bollocks for 200 yrs for nothing!"
5/ A reluctance to engage with aerosol transmission may even underpin the nonsense about the west being prepared for flu but not Covid. Flu was seen as unstoppable but for reasons never properly explained. That was not the case in mask wearing parts of the world like Singapore...

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More from @PaulNuki

8 Mar
1/4 Tony Blair intervened to save the Windsors after Diana's death. Boris (for it is he) must try to do the same today. The family's fragile legitimately rests on it representing the *entire* nation and the skin colour bile utterly undermines that...
2/ The deep outrage and offence it has, and will continue, to cause should not be underestimated. There will be lame attempts to pass it off as one Phil's bad 'jokes' but it won't wash... telegraph.co.uk/news/2021/03/0…
3/ Meghan offered this get out of jail card: "There's the family, and then there's the people that are running the institution, those are two separate things and it's important to be able to compartmentalise that because the Queen, for example, has always been wonderful to me."
Read 4 tweets
5 Jan
1/5: Medical triage (rationing) in a crisis is a difficult issue but it needs to be confronted directly to prevent things getting much worse. We are now at alert "Level 5", meaning there is a *material risk* of NHS services being overrun, so I looked at it for today's paper...
2/ First, the news story. In the absence of national guidelines (more on that shortly), clinicians in Bath have drafted and circulated a detailed protocol for debate among doctors. The story is free to read here: telegraph.co.uk/global-health/…
3/ A news story can never do justice to such a complex subject but can spark debate. You can read the full draft protocol and accompanying background here. Note, the authors wrote it when deaths were low to encourage calm debate ... jme.bmj.com/content/medeth…
Read 9 tweets
4 Jan
1/4 What will PM say tonight? My guess is it will be a March-style national lockdown, with many schools closed. Here is some of the data driving the decision making. Note, school closures push the London/SE peak, taking pressure off a stressed NHS #COVID19 Image
2/4 These charts show impact by region in absence of widespread vaccination. Deaths in 6mth to July worse than last year - start in London and SE and spread across country. The reason: new variant is breaching current measures and infecting many more people... Image
3/4 Here is how it looks with vax rollout. Still worse than 1st wave unless we can get to 2m shots a week by January 1 - 4 days ago. We are currently at about 300,000 shots a week Image
Read 4 tweets
4 Jan
1/4 Quick thread on vaccine rollout globally. Key message: supply is super tight and will remain so for some time yet. Global coordination urgently needed... Israel ahead in % population but it is a small nation...
2/4 In terms of doses delivered - a indication of access to supply - China and US miles ahead and neck and neck. Expect India to race up in next few weeks. Remember China has been administering vax since the summer...
3/4 Doses administered gives an indication of a country's ability to scale up. Here US and Israel stand out, though scale of countries is vastly different....
Read 4 tweets
3 Jan
1/ This thread making a distinction between point of entry controls and blunt travel bans is a good one, although I'm not sure Oz and NZ are the best examples
2/ Super important to look at the plans of places like South Korea. Post SARS, they operated on the principle of find every case, isolate and track contacts in event of outbreak. This applied as much to airports as it did bars and hospitals etc apaci.asia/images/Resourc… Image
3/ It seems to me that if you have a track and trace system which says, we will check everything except the ports and airports which are very busy and therefore expensive to check, you don't really have a track and trace system at all
Read 4 tweets
25 Oct 20
1/ Super interesting new info coming out on Exercise Cygnus, the 2016 dry run for a UK outbreak, since its formal publication was forced least week. Raises some important questions on current response... #COVID19
2/ First the sexy bit. Jeremy Hunt, then health minister, "stopped playing" on first day of exercise after being asked to turn off the ventilators of 4,000 people. He says it was 'morally repugnant' and prompted a rethink on triage. Not all agree... telegraph.co.uk/global-health/…
3/ “The hospitals were full and Hunt was asked to make the call as part of the exercise. But instead of doing so he basically said ‘I’m not playing anymore’. People were very cross as it mucked up the exercise”, said one source.
Read 11 tweets

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