Tweet

Paul Nuki

18 Apr, 9 tweets, 4 min read

Revealed: Why Britain’s regulator missed the link between the AstraZeneca jab and rare blood clots telegraph.co.uk/global-health/…

2/ We confirmed the first three cases of CVST+H happened in Jan and Feb. Two life-changing events and one death. The first Yellow Card came in, say the MHRA, on 8 Feb - the day the vax launched in Europe. Why were these and other early signals missed?

3/ We identified three reasons. First, the "sensitivity" of the algorithms/processes used by MHRA were lower than in parts of Europe. We tracked against background rates, while others turned the sensitivity dial up to 11...

4/ This is, in part, a function of resources. More sensitivity = more leg work. Observers say this should be seen in the context of the “operational and logistical challenges” the MHRA faced in becoming a sovereign regulator on Jan 1 - bang in the middle of a pandemic...

5/ Which points to a second point: The MHRA lost access to Eudravigilance, the vast European database into which all adverse drug reactions are reported, at the same time - the very point we needed it most. See quote below from EMA....

6/ The old tension between transparency and paternalism may also have played a part. EU regulators took a very modern and open approach, the MHRA really didn't. Those first reports of early mid Feb were not mentioned until 18 March. We have since identified 100 CVST+H cases...

@d_spiegel

7/ The reason all this is important has less to do with the jab itself than good comms and regulation. Even at a 1/100k incidence, the risk is tiny. As @d_spiegel points out, you have about the same chance as guessing the last five digits of a stranger's mobile phone number....

8/ The real question is this: Had the MHRA been quicker and more open, might it have been better able to shape reaction and policy towards the AZ globally? For make no mistake, the AZ vaccine remains vital for fighting #COVIDー19 around the world, esp in developing countries...

@TelGlobalHealth

9/9 The full story is here. Ii is OPEN and FREE to read 🔓🔓🔓 @TelGlobalHealth

telegraph.co.uk/global-health/…

• • •

Missing some Tweet in this thread? You can try to force a refresh

This Thread may be Removed Anytime!

Twitter may remove this content at anytime! Save it as PDF for later use!

More from @PaulNuki

Paul Nuki

@PaulNuki

10 Mar

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...

Read 5 tweets

Paul Nuki

@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

Paul Nuki

@PaulNuki

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

Paul Nuki

@PaulNuki

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

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...

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

Read 4 tweets

Paul Nuki

@PaulNuki

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

Paul Nuki

@PaulNuki

3 Jan

https://twitter.com/clarewenham/status/1343995195667394560

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

https://twitter.com/clarewenham/status/1343995195667394560

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…

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

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Share this page!

Paul Nuki

Try unrolling a thread yourself!

More from @PaulNuki

Paul Nuki

Paul Nuki

Paul Nuki

Paul Nuki

Paul Nuki

Paul Nuki

Did Thread Reader help you today?

Like this author's thread?