1/ Gosh, I see tomorrow's Commons spectacular is to be co-chaired by Jeremy Hunt. This is odd because in the field of pandemic planning (which he ran between 2012-2018) he is best styled as not so much as grand inquisitor but *chief defendant* ...
2/ Mr Hunt is huge on the "everything-would-have-been fine-if-it-had-been-flu" defence. This after all was the title of our plan - the UK Influenza Pandemic Preparedness Strategy 2011....
assets.publishing.service.gov.uk/government/upl…
3/ But this is tosh. It's no defence at all and it is important to understand why.
First, influenza comes in a huge range of different forms. It can be fast or slow, mild or devastating. This is true of seasonal flu but especially so for pandemic varieties ...
4/ Mr Hunt & Co have put it about that influenza is "unstoppable" in order to explain why the UK pandemic plan had no suppression element. But here you can see social distancing measures put in place to stop Covid-19 have also stopped flu worldwide...
5/ Another line being rolled out is that Covid-19 can be passed on by asymptomatic carriers but influenza cannot. I can't see this helps with a defence of the UK pandemic strategy but it's balls in any case. Influenza is also transmitted asymptomatically ....
6/ But what really sinks the great influenza excuse is that several countries had influenza plans which also incorporated suppression measures. NZ's plan of 2017 is a crystal clear example: health.govt.nz/publication/ne…
7/ Singapore is another good example. It is also the country with the best-named pandemic strategy: "Pandemic readiness and response plan for influenza and other acute respiratory diseases [like Covid-19]".
It moved on Jan 2, 2020 to suppress the virus ncbi.nlm.nih.gov/pmc/articles/P…
8/ Footnote: Every time I mention Singapore on Twitter someone gets in touch to say did I know that the UK helped draft its pandemic strategy. Having read the strategy, I suspect that if they ever took a call from PHE they were just being polite.

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More from @PaulNuki

24 May
1/ There's a lot of balls circulating about the UK's pandemic response and specifically *herd immunity*. Yet most of it is fully documented. Here's a thread pulling together some of the key points...
2/ Did the UK have a herd immunity strategy? YES, it was always the default. We had no other plan. The idea of suppressing the virus via lockdown etc was made up on the hop in late March when it became clear the NHS would be overwhelmed. Everyone knows that.
3/ Why did we not have a suppression plan? This is more interesting and the answer is that the DH/PHE/Cab Office explicitly rejected the idea when it reviewed the nation's pandemic strategy in 2010/11 assets.publishing.service.gov.uk/government/upl…
Read 17 tweets
22 Apr
BREAKING: New data on UK variants out from PHE....

1/ South African up 70 on last week, as results of surge testing in London start to come through...
2/ India up 55 to 132 total. Rapid growth, albeit from a low base...
3/ P1 from Brazil up 20 to 60
Read 4 tweets
18 Apr
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... Image
Read 9 tweets
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
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

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