1/ Following the Prime Minister's decision to be photographed, in Hexham Hospital, without a mask (despite everybody around him wearing one), I thought I'd look out the current guidance.
2/ (He clearly made a point of being filmed and photographed without a mask, and ensuring that those images were widely circulated…
3/ (…Whether this is a defiant dig at the mask-wearing rules he knows are necessary, but he hates, or another of his "dead cat" distraction ploys to draw attention away from gathering scandals, it was clearly deliberate.)
4/ England's Winter Plan is at gov.uk/government/pub… . It says on p16 "Wear a face covering in crowded and enclosed settings where you come into
contact with people you do not normally meet."
5/ As far as I'm aware the guidance emphasised in July at england.nhs.uk/2021/07/nhs-pa… still applies. It says:

"NHS Patients, staff and visitors must continue to wear face coverings in healthcare settings".

No exception there for politicians, not even ministers or prime ministers.
6/ In the meantime, as long as incidence (cases per 100k popn per week) remains above 10, the risk of your being infected is high enough that we should all be following the guidance in the winter plan.
7/ With case numbers at current levels mask-wearing should be mandatory, not just in hospitals (as it is at present) but in other places where people mix.
8/ And, of course, we should have tight regulations to ensure good ventilation/filtration to remove infectious particles from the air, in hospitals, shops, schools, workplaces, etc.
9/ It may be that after three doses of vaccine the chances of being infectious are so low that we can stop worrying about people who have had their three doses being infectious
10/ But we don't have the data to show that yet, and we don't know how long it would apply (will thre-dose protection wane and, if so, how quickly?)
11/ And, even if we did have data on this, the NHS app considers that two doses = "fully vaccinated"; and, if you have a third dose, it doesn't appear on the Covid certificate part of your app.
12/ (You can find confirmation of your third Covid vaccine dose it if you hunt - under one-off medicines - but you'd have to risk sharing private information to show it to somebody.)

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More from @petermbenglish

8 Nov
1/ I just made a complaint to the BBC about the use of visors without masks in clips on Strictly Come Dancing this weekend.

Please add your complaint at bbc.co.uk/contact/compla…

The text of my complaint follows.
2/ "We have known since early 2020 that visors without masks are worse than useless at preventing Covid-19 transmission.

"Despite that, many people believe that they are effective, and wear them in the false belief that they are protecting themselves and/or others.
3/ "As Chair of the BMA Public Health Medicine Committee, I was closely involved with BMA messaging to try to correct this false belief - I can't seem to find the infographic we created on the BMA website any more, but see eg bma.org.uk/news-and-opini… .
Read 9 tweets
5 Nov
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.
Read 16 tweets
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

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