The pandemic has been especially dangerous in nursing homes, and many handled it badly (yes @andrewcuomo that includes you). This from the U.K. includes some retrofitting of what we did and didn’t know, and what experts would have advised 1/n…
Starting point is that we have known a long time that outbreaks of respiratory infections are deadly in nursing homes. I and many others have written about that in the past. The danger was expected but not prepared for 2/n
This from @DHSCgovuk is shameful. I was watching the evidence at the time. I and most of my colleagues thought some asymptomatic/presymptomatic transmission was likely. This misrepresents the state of the science at that time, and what about the precautionary principle? 3/n
Except the discharge was neither safe nor timely. Being able to get a test now is no comfort to the relatives of anyone who died then, infected by someone who was not tested then. Testing capacity don’t travel in time; it was bad then and it would be better to own it 4/n
Look at this from early April 2020. We (ID pros) knew what was happening and tried to warn about it. And we were ignored, and now the people who did the ignoring are making excuses 5/n
To learn from mistakes you need to admit them. This is only one of the many reasons that public inquiries into pandemic failures are necessary, because the making of the same mistakes over and again has gotten tired 6/end

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More from @BillHanage

9 Jun
The US has (overall) pretty good levels of vaccination by now and this is excellent and *everyone* involved deserves credit - but the virus is not gone and it is wrong to pretend that it is (teeny slightly ranty thread)
First we have a new variant on the scene (Delta) which is pretty unambiguously worse than its predecessors. Already about 6% of cases and climbing
Then there are a bunch of states in the south that experienced a surged over the summer last year. Some of them are mooting shifting to once a week reporting, which is not a good idea…
Read 9 tweets
4 Jun
So growth rate and R number in the UK now over 1. Unsurprisingly given that Delta variant now dominant. A short thread on the next few weeks there, which will be (sorry) big on uncertainty… 1/n
That's quite a large increase. The caveat of course is that it is from a *very* low base indeed. And cases will not necessarily translate into severe illness, especially in vaccinated people 2/n
Unfortunately these too are up, from a low baseline. This should be treated with caution because when numbers are this low they can be impacted by unusual events like clusters of infection in vulnerable populations - although you'd hope such folks were vaccinated 3/n
Read 9 tweets
3 Jun
Have digested the latest excellent technical briefing from @PHE_uk on variants and Delta (the variant formerly known as B.1.617.2) in particular. as ever, all findings are context dependent and should be interpreted with care, but this is serious and deserves a wide audience 1/?
First, read all about it yourself (don't take my word for it!). Briefing here… and Risk Assessment… 2/?
This is from the risk assessment. Yes there is a lot of red. There is now very good evidence of increased transmissibility (will come back to that) compared with Alpha/B.1.1.7 (already quite transmissible). This is important. There is also... 3/?
Read 18 tweets
2 Jun
I read this article this morning and it made me uneasy, I've just figured out why. Not linking deliberately although easy enough to find if you really want to 1/n
The article admits that a definitive answer on the origins of the pandemic is probably never going to be available (I agree), and then proceeds as if it were. This is silly 2/n
If there will never be a definitive answer to the question, why act like there will be? In its absence people will pick sides based on pre-existing positions rather than accepting uncertainty. And the thing is we'll be better off in the future accepting that uncertainty 3/n
Read 6 tweets
27 May
I was wondering earlier today if change was afoot in the UK due to B.1.617.2, but @jburnmurdoch's thread is better than anything I could put together. It deserves your time. I do think it misses something out however. Hospitalizations are climbing much earlier than I'd expect 1/n
First it certainly looks like B.1.617.2 has become readily established, and is sweeping in multiple different places suggesting that it is more transmissible even than B.1.1.7, itself no slouch. IMO we can't put this down to founder effects/networks 2/n
(I still don't understand why given what *looks* like high transmissibility it has an MRCA so far back, but it's clearly capable of causing outbreaks like these. That's enough to take it seriously) 3/n
Read 14 tweets
26 May
A few points about "Chicken Pox parties", and why they should never have been part of any serious discussion of pandemic management… 1/n
Like Covid, chicken pox is more likely to lead to severe illness and complications the older you are when you are first exposed. In the UK in the 1990s about 25 people died every year of the infection, 80% being adults… 2/n
It is generally thought that on recovery from chicken pox immunity is lifelong. As a result in the 70s and 80s some people would arrange for their kids to be infected at an age they would be at lower risk of complications. This is not a good idea 3/n…
Read 8 tweets

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