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Dr Raghib Ali MD(Epi) MPH MSc(Epi) MA DLSHTM FRCP Profile picture
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17 Nov, 5 tweets, 2 min read
Oct 22: A common view
"We need to adopt plan B, on masks and vaccine certification – Europe has shown it works
"Germany is managing to control its Covid epidemic and bring down the numbers of cases & deaths."
theguardian.com/commentisfree/…
Oct 23: I explained why this was flawed &
1/4
why our high rates shouldn't be assumed to be due to our lack of Plan B measures but because:

"other countries are at different stages of their third waves & their immunity will wane later than in the UK because their vaccine programs started later."

telegraph.co.uk/news/2021/10/2…
2/4
Some people were so upset that I was challenging 'their consensus' they reported me to the GMC & my employers!
My point here is not to say that I was right & they were wrong (mistakes are inevitable when evidence is uncertain) & I'm not asking for an apology but I hope that
3/4
those who made/are making calls for Plan B recognise that those with a different view - based on the evidence - do not have bad intentions or care less about Covid, and that they recognise that their certainties were misplaced and learn lessons from what has actually happened.
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More from @drraghibali

Dr Raghib Ali MD(Epi) MPH MSc(Epi) MA DLSHTM FRCP Profile picture
15 Nov
This is despite mask mandates & vaccine passports - as was predictable (& predicted) based on timing of delta wave & waning immunity.

But why are rates rising faster in Ireland (& eg. Austria, Germany & Belgium) than e.g. UK, France, Spain & Italy?

1/4
 thetimes.co.uk/article/irelan…
It's not clearly linked to levels of vaccination (or restrictions) but the pattern is more consistent with the total levels of population immunity (from combined vaccination and natural infection) i.e. rates are going up faster in countries which had less infections before
2/4 ImageImage
the vaccine program was complete & so they have higher numbers of (esp. younger) people who are susceptible.
It's difficult to show this definitively as there aren't serology surveys in most countries, and there are differences in testing & the way Covid deaths are recorded

3/4
Read 4 tweets
Dr Raghib Ali MD(Epi) MPH MSc(Epi) MA DLSHTM FRCP Profile picture
12 Nov
Important paper on deaths in children & young people (CYP) in 1st year of pandemic. Reassuring results for Covid:
- of 12 million CYP in England, 3105 died
- of these, 25 (<1%) were due to Covid
- 99.995% of CYP with positive test survived
However..
1/6
 nature.com/articles/s4159…
..as Dr Camilla Kingdon, the president of the Royal College of Paediatrics and Child Health, said:

Meanwhile, successive lockdowns and social distancing caused far greater consequences “through lost education, mental health, and other collateral damage”,

2/6
"But what we would constantly try to point out – and which some of this data shows – is actually, these are wider issues that are no less detrimental to children and may have a more long lasting impact actually, then the virus itself,”

3/6
Read 7 tweets
Dr Raghib Ali MD(Epi) MPH MSc(Epi) MA DLSHTM FRCP Profile picture
9 Nov
A brief thread summarising our current COVID situation and what we can expect going forward - and why - although Covid is by no means over - we should be cautiously optimistic about the coming months:

1/9
First, although it’s easy to forget this given some of the commentary, the situation is so much better now than this time last year when hospital admissions & deaths were much higher and doubling every 2-3 weeks - and we were in lockdown - with all its harms.

2/9
Admissions are now about half & deaths about a third of what they were then and both are falling.
And we have no restrictions; society and the economy are open and unemployment is falling.
So we have less direct & indirect health harm from Covid and also from restrictions.

3/9
Read 11 tweets
Dr Raghib Ali MD(Epi) MPH MSc(Epi) MA DLSHTM FRCP Profile picture
23 Oct
@dgurdasani1
Do you really think that someone who has spent their career trying to save lives & put their own life at risk by volunteering to work, unpaid, to save the lives of Covid patients is now trying to justify policies that lead to mass infection, disability & death?

1/
Although it’s tempting to respond in kind, I prefer to assume those who disagree with me are acting in good faith and also want to reduce death and suffering even if- based on my interpretation of the evidence- I believe their policy recommendations are wrong or even harmful.

2/
Of course we may differ on how to achieve that aim, as do other scientists/doctors, and differences are inevitable given the uncertainty of the evidence.
But I would hope that all of us would respect that all are sincere in their intentions.

3/
Read 12 tweets
Dr Raghib Ali MD(Epi) MPH MSc(Epi) MA DLSHTM FRCP Profile picture
21 Oct
Seven persistent myths about Covid and lockdowns in the UK / England.

I thought I would put one thread together on what I think are 7 myths that continue to be propagated - mainly by those who, although well-intentioned, always assume that more restrictions are the answer.
1. The UK has had the highest Covid death rate in Europe during the pandemic - mainly due to being late to lockdown twice. (see myths 2 and 3)
Even compared to EU countries, the UK would be 11th on Covid deaths & 15th on excess deaths (20th in all Europe)
economist.com/graphic-detail…
2. Thousands of lives would have been saved if we had locked down earlier in the first wave.

Most of the countries with higher death rates (shown above) did lock down early & had small first waves followed by very large second waves.
Discussed more here:
telegraph.co.uk/news/2021/03/2…
Read 13 tweets
Dr Raghib Ali MD(Epi) MPH MSc(Epi) MA DLSHTM FRCP Profile picture
21 Oct
To those calling for a return to restrictions, a reminder of some criteria I set out last year that should be used before suppression measures are implemented:

i) Evidence for effectiveness in reducing cases
(particularly in over 60s) hospital admissions & deaths

(1/4)
ii) Evidence that a mandatory approach produces better outcomes than a voluntary one.

iii) Evidence that a blanket approach produces better outcomes than a targeted one. e.g. on adherence, suppression

(2/4)
iv) Evidence for broad public acceptability with high levels of sustainable adherence.

v) Most importantly, that the intervention has been shown through transparent impact-benefit analysis to produce less overall harm. (Health in QALYS, cost per QALY saved.)

(3/4)
Read 4 tweets

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