1/ People with a Great Barrington Declaration bent ("don't do anything to control Covid-19 and hang the consequences - who cares how many people will die...") are now attacking the rest of us for saying we should continue to do what we can to control the disease.
2/ "You want it to go on for ever", they say, echoing the prime minister's "if not now, when?" questions.

It's a complete straw man attack. We have never said that.
3/ There are some discussions about whether we should try to eradicate the virus completely; or just bring it down to controllable levels.

But nobody's saying we need to take precautions for ever.
4/ Right now, case numbers are ridiculously high - the UK stands out like a sore thumb compared to other Western European countries. We have been extremely complacent.

If you are vulnerable or susceptible, you are not safe. There is too much transmission.
5/ The risks of catching it are much too high.

Decisions are being made that discount the long-term consequences of Covid-19, which we know young people are susceptible to, too.
6/ We really need to keep wearing masks in schools, public transport, shops and other enclosed public spaces (and MPs and ministers should be modelling good practice, rather than undermining their own guidance).

Not forever.
7/ But until case rates drop to no more than 10 cases per 100k population per week.
8/ At those levels the risks will be very much lower; and it will be possible to identify cases and their contacts early, and to ensure that they - and their contacts - are required (and supported, even paid - they are acting on behalf of the public) to do so.
9/ And thereby to keep case numbers low.

We will get the case numbers down. We could do it relatively quickly and relatively painlessly by bringing back (and strictly enforcing) mask mandates, standards for ventilation (relating to crowding) and air quality…
10/ (That's another straw man attack used by the GBDers and the "Covid Recovery Group" of Brexity MPs, by the way: the idea that public health advocates want to bring society to a halt with another full lockdown.
11/ Actually we're only calling for people to wear masks, and better ventilation...)
12/ Or we can wait until vaccination brings herd immunity up high enough - which will only happen when a high proportion of the population has had three doses of vaccine at appropriate intervals (probably ≥6 weeks between 1st and 2nd dose; ≥3 months between 2nd and 3rd).
13/ It will take us a long time, at current rates of vaccination, to get there; and the longer we take, the more people will get sick, get Long Covid, require critical care, and die.

So we really should bring back the measures that work.
14/ And those people who say that mask-wearing is "a sign of cowardice" or an infringement on their liberties (often raising completely spurious and unfounded "science" to claim masks are dangerous)…
15/ …What these antimaskers are actually saying is "I don't care who I infect, or if anybody dies because they caught Covid from me…"

It is a sign of having a complete absence of compassion or care for anybody other than themselves. I have no sympathy whatsoever for them!

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More from @petermbenglish

3 Nov
"Should single rooms be the default for NHS inpatients?" posits @mancunianmedic.

Obviously, it's not possible now, and could take several decades.

The current pandemic - and the previous flu pandemic - emphasised the need for more single rooms…
1/4

bmj.com/content/375/bm…
We needed more single rooms, ideally with negative pressure lobbies, to prevent transmission of airborne diseases.

Covid-19 won't be the last such pandemic.

So, if only for infection control purposes, we need more such rooms.

And yet…
2/4
I looked into the regulations during the flu pandemic.

Not only were there no standards for the number of respiratory infection safe rooms a hospital (even new-builds) should have, regulations on eg the minimum distance between beds were extremely weak or non-existent.
3/4
Read 4 tweets
31 Oct
@lisa_iannattone @greg_travis @fitterhappierAJ @COVIDforKids I'm not sure I understand this tweet.

It has long been policy to vaccinate eg HCWs against chickenpox if they are not immune and, using effectively a bigger dose of the same live-attenuated virus vaccine, to vaccinate older people to prevent shingles.
1/
@lisa_iannattone @greg_travis @fitterhappierAJ @COVIDforKids The live attenuated virus vaccine causes shingles much less often than wild chickenpox virus.

We now have a (more effective) subunit vaccine for shingles. It can't cause shingles.

It has long been argued that shingles is much more serious than chickenpox.…
2/
@lisa_iannattone @greg_travis @fitterhappierAJ @COVIDforKids … (Which is true.)

…And that "natural boosting" via exposure to children with chickenpox boosts immunity and thus prevents/delays shingles.
3/
Read 14 tweets
27 Oct
1/ The BMA @TheBMA has responded to the Police, Crime, Sentencing and Courts Bill.

NOT IN MY NAME!

I fully agree with the BMA parliamentary brief re confidentiality; but not re increasing sentences.
2/ Apparently @TheBMA “supports the Bill’s intention to increase sentencing for those convicted of abusing an emergency worker”.

Prison is an extremely expensive way of making bad people worse. We should be calling for decreases in prison time, not increases.
3/ The problem is NOT the sentences people receive.

The problem is NOT the lack of offences in law under which to prosecute them.

The problem IS the failure to investigate and prosecute cases.
Read 5 tweets
26 Oct
1/ (Second attempt to publish this thread: for some reason a glitch meant that only the first few tweets were published on my last attempt.)

Thanks for putting this list together, Edwin @uk_domain_names - very interesting.

2/ I am a little uncertain what to make about this huge twitter storm about sewage.

tl;dr - it is a hazard; but it's a very low level of risk to health or to the environment.

There are more important things to worry about.
3/ Until I retired in January, I have been a consultant in communicable disease control since Feb 1998. Part of this job has always involved liaising with water companies over incidents etc., and with emergency planning bodies including local authorities.
Read 29 tweets
26 Oct
1/ Thanks for putting this list together, Edwin @uk_domain_names - very interesting.

I am a little uncertain what to make about this huge twitter storm about sewage.

tl;dr - it is a hazard; but it's a very low level of risk to health or to the environment.
2/ There are more important things to worry about.
3/ Until I retired in January, I have been a consultant in communicable disease control since Feb 1998. Part of this job has always involved liaising with water companies over incidents etc., and with emergency planning bodies including local authorities.
Read 4 tweets
25 Oct
Hi, @djnichol!

There's no law saying that you must be vaccinated against hepatitis B if you're a healthcare worker. Not per se.

But there is a duty or care to patients; and the risk of liability if you infect them through failure to get vaccinated.
1/5
There is a duty on the individual, and on the body employing them; so it may be that the employer will make it a requirement (at least for HCWs undertaking Exposure-prone procedures).

And there's a professional duty under GMP for doctors (and likely equivalent for others)…
2/5
So you risk losing your registration/license to practice if you don't get vaccinated against Hepatitis B and do a job which involves undertaking EPPs.
3/5
Read 5 tweets

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