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Dr Philip Lee Profile picture
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7 Apr, 6 tweets, 1 min read
The chances of developing an HITT like reaction based on the number of cases/doses so far with AZ vaccine is 0.000344%

The chances of developing an HIT with heparin is around 0.2%, we give nearly all hospital admissions a form of heparin to prevent blood clots.
This really is a true "abundance of caution"
To be clear, I am not a vaccine expert, nor am a pharmacovigilance expert.

I suspect the decision might well have something to do with Moderna, Janssen, and Novavax coming online by the time we vaccinate under 30s.
Anyway I wonder what my evil doppelganger with hats will say about this
Oh wow, I've just had a look and
Interesting, I missed this as I was working. This might explain the decision re: most under 30s, as the risk benefit balance is not as clear in this group.

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Dr Philip Lee Profile picture
17 Mar
This appears to reflect more that Pfizer vaccines are made in Europe, and Astra Zeneca is produced in the UK; and that on the continent there's higher vaccine manufacturing capacity.

Besides sending OxAZ to EU to end up in the 🗑️ might not be the best use.
I find the whole "who made what where" argument distasteful. We need Europe to vaccinate as much as we do to protect us, as well as them. Having large outbreaks in your closest neighbours risk a vaccine resistant variant entering the UK.
The part where VdL made it clear that countries with a higher roll out rate than in the EU will be targeted for export bans is especially galling.
Read 4 tweets
Dr Philip Lee Profile picture
1 Feb
Not a virologist or epidemiologist, but I think it'll be a big challenge to persuade people that *some* level of social distancing measures need to remain even after all the >50 and clinically extremely vulnerable have been vaccinated.
The current strategy seems to be having the vaccinated to act like a shield wall, containing the virus in the less vulnerable population and prevent serious disease. This should stop healthcare systems being overwhelmed.

However, the virus will still be around.
With a lack of data in whether vaccines prevent asymptomatic/low grade symptom transmission, it's not safe to assume once you've had the vaccine you will not pass it on. (Though it'll be interesting to see what comes out of UK and Israel)
Read 6 tweets
Dr Philip Lee Profile picture
31 Jan
One of my favourite facts about Paris, it's one of the few cities with an entirely separate "grey" non potable water supply, from the canal de l'Ourcq, for street cleaning, fountains, watering parks etc.
Visitors will often notice (well I do cos I'm weird) water running down the gutters gushing from what might look like water leaks.

They are in fact deliberate, directed by a roll of old rug the street cleaners carry
Which then allows the hard working men and women in green of Propreté de Paris to sweep the gutters clean.
Read 8 tweets
Dr Philip Lee Profile picture
23 Jan
I see that Germany, France, and Austria are considering mandating FFP2 masks in crowded places.

Frankly negligent of them not also mandating the Omnipotent White Plastic Apron (OWPA™®) as per UK guidance.
🇪🇺: oh yeah wear that mask on the 🚉

🇬🇧: wear what you want loser but when you come to work in a hospital have this surgical mask and an apron
👩‍⚕️*gets covid*

it's because of this flimsy mask when someone coughed in my face

🇬🇧Well were you wearing your PPE?

👩‍⚕️yes

🇬🇧ALL OF IT EVEN THE EYE SHIELD

👩‍⚕️well I took off the goggles

🇬🇧IT GOT IN THROUGH THE EYES CASE CLOSED PEOPLE
Read 4 tweets
Dr Philip Lee Profile picture
22 Jan
France: non French Healthcare workers put their lives on the line for us, please have a French citizenship.

England: oh thank you for your service but if you don't have British passport then no vaccine for you.
theguardian.com/world/2021/jan…
It's been pointed out to me that this is not the dhsc/nhse position, and that staff should be vaccinated regardless of whether they have an NHS number.

This does not negate the fact that at least one trust has taken the position not to vaccinate without.
For an organisation that has extensive requirements for training and awareness about indirect discrimination, the NHS trust seems blithely unaware how their policy will disproportionately affect staff less likely to have an NHS number.
Read 4 tweets
Dr Philip Lee Profile picture
19 Jan
If I hear any medical student ever describe the work of HCAs as menial, rest assured I would not want your assistance, paid or not, on our wards.

In fact you can go home, stay there, and never come back to the hospital.
Whilst I sympathize completely with having upcoming exams, needing time to study, and I will make the utmost effort to continue teaching you despite everything else, the most important lesson is that there is no task that is beneath anyone in healthcare if it helps the patient.
Also, here's a bit of training for free. If you ever find yourself writing a letter like this, write it, leave it for 12-24 hours, read it again (ideally get someone else to read it too) and think about how it comes off, then send it.
Read 4 tweets

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