Thread by @globalhlthtwit

Control of the global pandemic is a balance between achieving population immunity (vaccines, natural infection) and containing/suppressing/eliminating the virus through public health measures (find, test, trace, isolate, behaviour change). Lockdowns are a sign of failure. (1)

Countries that implemented public health measures at speed (S Korea, Singapore, Taiwan, Vietnam, China, Thailand, Finland, Iceland, Denmark etc) avoided national lockdowns and their terrible economic effects. And have far, far lower death rates. (2)

Attention to local public health detail is essential...isolate all people with suspected symptoms, rapid test results, one community worker per 1500 population in teams of 5-6, links with primary care teams +data, supported + monitored isolation, reimbursement to all. (3)

We failed to do this last March, last July, last September. We still haven't invested in local public health teams. Last week a district PH director said he has 19 contact tracers, not the 100 he needs, funded by his routine budget, not the £37 billion wasted by outsourcing. (4)

So our government and advisers pursue a vaccine and lockdown policy only, causing huge economic damage. I hope high vaccine coverage will solve the problem. But we could have avoided so many deaths and lockdowns if we had invested in proper local public health. (5)

@CMO_England was right to emphasise the inequalities in our country and @uksciencechief the importance of FTTI as cases fall. But our find, test, trace and isolate system can never be fit for purpose without local investment to ensure contact tracing and isolation.(6)

The best case scenario right now is that high vaccine coverage plus natural infection in the young will create population immunity and free us all from restrictions. (7)

But @CMO and modellers predict further surges. The British variant is far more transmissible +increases severity of illness in younger people. We cd see many more cases and hospitalisations in people under 65. We must invest in local contact tracers and finance for isolation. (8)

We cannot eradicate the virus from the earth. Zero Covid aims to eliminate spread from countries but yes is inherently unstable. New outbreaks are a risk: an even bigger reason to have local public health teams to suppress them quickly as in Asia. (9)

The S. Africa variant is 10% of cases in France + appears largely resistant to AZ vaccine. It cd replace the British variant as cases fall here. I simply don't understand why UK policy is vaccines or lockdowns, + ignores local FTTI teams. And why govt advisers say nothing.(10)