1/ Some great infographics in this piece for those interested in the challenge of vaccinating the world. A quick thread...
telegraph.co.uk/global-health/…
2/ First, the extent to which vaccine manufacturers overestimated early supply is horribly marked - and explains many a dashed expectation...
3/ On the other hand, we will - by the end of the year - have enough vaccine for everyone on Earth. No small achievement...
4/ But - and it's a big but - distribution is currently terribly skewed towards richer nations. We have not just bought up most of what exists but we have taken out 1st options on most future supply....
5/ This, combined with the crisis in India, has left #COVAX without the stocks it desperately needs to vaccinate the developing world's health workers and most vulnerable...
6/ As scientists including @JeremyFarrar and Sir John Bell argue in the @telegraph today, world leaders need to FIX THIS FAST or the pandemic will not stop anytime soon. They specify 5 reforms and the first is sharing doses... telegraph.co.uk/global-health/…
7/ So who is sharing most currently as a proportion of what they have? It's embarrassing but of the big producers, it's China followed by the EU. Most others are far behind...
8/ All countries need to share doses but all eyes will be on the US at the G7 later this month. It has vaccinated much of its population and holds the key to accelerating the rollout to much of the rest of the world...
9/ Will Joe Biden @POTUS turn on the mRNA taps and start exporting vaccine in bulk to the developing world? Or will he continue to leave it to China to try and save the world with lesser vaccines? We'll have to wait and see....

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More from @PaulNuki

30 May
1/ Lots of debate as to why ~40,000 vulnerable people died of Covid in care homes in England and Wales and who was to blame. Yet the road to this particular tragedy is well documented. A thread...
2/ First, it's important to note the cull of care home residents is a failure on the gov's OWN terms. As detailed below, Whitehall never planned to stop a new virus. But it was, from 2017, supposed to have plans in place to protect care homes
3/ How do we know there was supposed to be a plan? Because it is one of the key recommendations to have come out of Excercise Cygnus, the 2016 dry run for a pandemic. In short, Whitehall ordered itself to produce a plan for care homes assets.publishing.service.gov.uk/government/upl…
Read 19 tweets
25 May
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 ...
Read 8 tweets
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

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