Thread by @dgurdasani1

It's not a choice between vaccines & mitigations - lockdowns represent a failure to control transmission pre-emptively. What's needed is a multilayered approach of vaccines + boosters + mitigations (high-grade masks, school mitigations, ventilation, test, trace, isolate)

https://twitter.com/Nieuwsuur/status/1463248881819525123

We must separate out lockdowns & mitigations. Lockdowns are only needed again and again if we don't have robust mitigations in place. Many of these don't require a huge sacrifice, but are highly effective (masks indoors, ventilation). There needs to be strong messaging about this

It's not right to say 'restrictions' will be needed for a long time because it will prevent build up of population immunity by infection. Immunity by infection is not desirable- because it's by infection! - which we're trying to prevent! Vaccines do this safely & effectively.

There's no reason long lockdowns should be needed if the right public health measures have been in place throughout (not just when cases get out of control), and pre-emptive action is taken to suppress when cases start rising. Response needs to be data driven.

Schools are a major area of spread. Yet almost nothing has been done to contain this. Other countries in Europe have strict measures in schools - high grade mask mandates, bubbling, ventilation, and robust test, trace and isolate systems. These are essential to keep schools open.

So if you do want to keep schools open, avoid restrictions as you say, the best way to do this is mitigate - have mask mandates, resource ventilation in workplaces, schools, identify children infected, isolate contacts of children who are infected, vaccination of children.

Alongside roll out of vaccines, messaging around vaccines, and boosters, which are hugely beneficial at this point in time, and can really reduce transmission as well as severe disease.

Multi-layered mitigations + vaccination + boosting all together prevent the need to be in long-term stricter restrictions. There's no point waiting till hospitals are overwhelmed to act. There were many opportunities to act early in NL, but these were missed.

Little mitigation in schools which have fuelled spread, and little attention and messaging to aerosol transmission, and high-grade masks, and ventilation. If a lockdown is needed, it's because of this late action. Early action prevents the need for long term stricter restrictions

So let's not present this as a binary choice. Even with high vaccination rates, mitigations are needed, and we need to be clear about this in our public messaging. And the only way to prevent lockdowns is to use effective evidence and data-based approaches to prevent spread.

And sadly that hasn't happened here, which is why hospitals are discussing code blacks. This is not on the public- it's on the govt and their advisors.