Whilst we contemplate a 3rd dose here’s what the @WHO says on boosters:

who.int/news/item/10-0…

To summarise:
👉🏻Give boosters if clinical evidence of ⬇️ vaccine effectiveness ( ⬇️antibody levels don’t count)
👉🏻Evidence for boosters inconclusive

/1
Whilst we contemplate our 3rd doses… meanwhile in Peru:
👉🏻Highest deaths per capita.
👉🏻1 in 100 children have been orphaned due to coronavirus.
👉🏻vaccine scarcity the key issue
/2


bmj.com/content/374/bm…
In South Africa:
👉🏻Its Winter & they are having a 3rd wave and have locked down
👉🏻20.4% of population have HIV (JCVI classified as CEV so higher risk of death)
👉🏻17.5% fully vaccinated. Key issue = vaccine scarcity & hesitancy

ft.com/content/b6a964…

bmj.com/content/374/bm…
/3
My conclusion (I can always be swayed with new evidence): it seems like we are choosing an unknown benefit for a person in a wealthy country over a massive, life-saving one for a person elsewhere in the world…🤔

Let’s see if new evidence comes out tomorrow.

END

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More from @DavidAttwood12

3 Sep
There is a strong case for Mr Pritchard to publish all income he receives. How that income is spent, what percentage of private work is undertaken and the hours he works? The government needs to call for more transparency & champion taxpayers' interests @Keir_Starmer. /1
I am also tiring of the lambasting of all GPs by Tory’s & their supporting newspapers. I tend to let this stuff wash over me but as @parthaskar has noted this feels sustained & is accusing my staff of being lazy, part time & not seeing patients. It’s time for facts and balance
/2
First fact: primary care sees 95% of patients on 9% of the NHS budget. That’s ~ £19 billion of the £212billion allocated for spending this year by Dept Health and socialcare. You may want to compare this with NHS track and trace back which had double the budget ~£37 billion.
/3
Read 14 tweets
26 Feb
🚨Today in West Devon🚨 @NHSDevonCCG & @Devon_LMC approved iCOPE (Integrated Care for Older People), the UK's first #populationhealthmanagement strategy for older people to be implemented.
/1
We will proactively identify older people across West Devon with reduced physiological robustness (aka medical diagnosis of #frailty) and offer evidence-based interventions & #Personcentredcare to support patients to achieve their goals (see plan on page below) 👇
/2 Image
It's based on @ageingwell @nhsrightcare Frailty Toolkit & is our local answer to #anticipatorycare spec in the @NHSEngland #longtermplan. It is:
👉Proactive & goal orientated
👉Community-based
👉Focusses on prevention
👉Identifies mild frailty so we can intervene EARLY
/3
Read 10 tweets
23 Jan
Apologies for inactivity on Twitter. Our #PlymouthCOVIDCollaborative has been hard at work. The task: vaccinate 80 carehomes, 1800 patients, 2700 staff, across 17 GP surgeries, in 5 #primarycarenetworks IN 10 DAYS. What follows is a brief chronology of events /1
Tues 5th Jan: I was asked to join amazing #Plymouth PCN COVID Collaborative team as #COVIDvaccination coordinator for #carehomes.
Thursday 7th Jan: 1st 400 doses of #astrazenecca arrive
Monday 11th Jan: 1st of 80 #carehomes to have AZ vaccines piloted in @PathfieldsMG PCN
/2
Tuesday 12th Jan: 3 other #primarycarenetworks - Drake, Waterside, and Mayflower - also pilot. Our city works well together and, true to Plymouth form, our #vaccteams are a mixture of teams from #primarycare and #communityservices (courtesy of @livewellsw) -thanks Livewell 🙏 /3
Read 14 tweets
26 Jun 20
I hear the words “Population Health Management” (PHM) MIS-used a lot. The clue is in all 3 words esp. the middle one. The goal is to focus on population HEALTH NOT getting older people out of hospital as fast as possible- that would be called Service Utilisation Management /1
The central tenant of PHM is that healthy people do not utilise healthcare—> reduction in healthcare utilisation. If we ask older people what matters to them, they nearly always say: to be happy, healthy and independent in a dwelling of their choosing for as long as possible /2
When designing a service based on PHM principles all we then have to do is work out the evidenced based interventions that support older people to be happy healthy and independent for as long as possible /3
Read 10 tweets

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