Today's briefing appears to be an exercise in doing the bare minimum while seeming to signal that our response is in someway proportionate to the potential threat. Let's be clear- this response doesn't even go far enough to deal with delta, far from dealing with anything beyond🧵
Let's remember we're entering a period of uncertainty and high *potential* threat with our NHS already under unsustainable pressure (something that doesn't seem to have been discussed at all during the briefing)! Ambulances are on black alert with emergency services struggling.
We've been having excess deaths and very high transmission for months, and are currently at 50K cases or so a day, and rising, esp in children. This has been accompanied by huge rises in self-reported long COVID in young people- something not addressed at all in the briefing.
We currently have >3% of health and social care workers suffering with long COVID, higher than any other occupation, with massive understaffing, underresourcing, and reduced bed capacity in hospitals and critical care - being made worse by COVID-19.
We are in a crisis. Even without omicron. There is literally no slack in this system. I seriously worry about what would happen if anything were to make the current situation - where people are already dying in the backs of ambulances - any worse.
While it is absolutely essential to slow the import and spread of omicron, it's critically important what we do with this time we're gaining, given the crisis we're already in. Here's what we should be doing:
1. Slow import as much as possible: Comprehensive managed border quarantines across all countries (this variant is no doubt widespread) and screening. Effective, test, trace, isolate, including backward and forward contact tracing + isolation with *adequate support*.
2. Slow spread of both omicron and delta - we cannot face this threat at current hospital capacity and strain on HCWs and NHS. So:
- mask mandates - high grade masks provided by govt in all indoor settings & outdoor crowded settings
-work from home where possible
-contain spread in schools: mask mandates like in most other European countries, and ventilation + HEPA air purifiers, bubbles
-caps on large gatherings
-isolation of all contacts
-speed up boosters & give earlier
-2nd doses for 12-15 yr olds
-extend vaccination to 5-11 yr olds
3. Prepare healthcare capacity:
The best way to do this is contain transmission with delta now, to avert the current crisis and create at least some slack in a system that's already functioning in a way that's likely unsafe because it's overwhelmed.
Plan and prepare for further pressure on the NHS, if this does arise - including emergency planning.
I'm so dispirited by how slow our response has been to every aspect of the pandemic. Mask mandates should've never been removed. Vaccine roll-out to children massively delayed.
As other countries take serious steps to prepare for a new variant that poses a high potential threat, we are essentially just telling people to wear masks in shops and on transport (which should've been happening anyway!), and considering giving boosters earlier. That's it.
Yes, we have single PCR tests after people enter (which of course won't catch many cases, especially infections during travel), and travel restrictions from a few countries in Africa (despite omicron clearly being far more widespread).
Worth remembering our policies are well behind most of Europe, where high-grade mask mandates are already in place in many countries, much stronger mitigations in schools, many countries with higher vaccination rates, and much higher coverage for children than us.
And one can rely on vaccines and say 'it'll be much better than before because of vaccines', but also remember, we have an NHS and healthcare force that's been devastated by 19 months of being hung out to dry - with many suffering from long COVID or PTSD.
Our human resource, which is our most important resource, is struggling, because of what looks like never-ending exhaustion, illness & trauma. Teaching staff, health & social care workers, other frontline staff. We are entering winter with much less resilience than before.
And a vaccine-only approach hasn't worked in any country so far, even in those with much higher vaccination rates than us. And we've already lost >15,000 lives to this approach since 'freedom day'. How many more deaths, and chronic illness are we willing to tolerate?
One might say things will be a lot better with boosters, and potentially children being vaccinated. But this takes time, and it makes perfect sense to use effective public health measures like high-grade masks, ventilation in the meantime to contain spread.
And for those who think all of this is alarmist, we went through this with delta. And we responded too late. When there is a potential threat, it's important to respond early, in line with its potential, until we understand more. That's not alarmist. It's basic pandemic response
Always better to take precautions, and scale back if the threat turns out to be at a lower level than anticipated, than to under react, which is what we've done since the beginning of the pandemic.

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More from @dgurdasani1

29 Nov
Just done an interview on 5 live, where there was a long discussion on Lilico's anti-mask statements. If we're still debating whether people should wear masks on transport & in shops at a point in time when our NHS is overwhelmed & a new variant is spreading, we're in trouble.
I think as the host of the programme mentioned I don't think the scepticism is as widespread as it's platformed on the media. There are several highly influential actors who are push out anti-vax and anti-mask rhetoric. It's important to go beyond this and address the reality.
In reality the idea that the public won't cope has been pushed by govt messaging for a long time. It's far likely that members of the Tory party won't cope, but the public will if the messaging is good. Messaging and role-modelling has of course been shambolic so far.
Read 7 tweets
28 Nov
Masking in 'communal areas'. Seriously? What is the evidence behind this? Do you honestly believe that transmission doesn't happen in classrooms where children breathe shared air for literally hours! @kprather88
Literally almost every other country, including in Europe have mask mandates in schools- both primary & secondary, and in some high-grade masks provided by govt. And they have far higher vaccination rates in adolescents, and lower infection rates than us!
Infection rates rapidly rising and highest in primary & secondary school children. Some of the poorest mitigations in schools across W. Europe, and no isolation of contacts required. Every new variant spread disproportionately through school outbreaks.
And we're doing nothing.
Read 4 tweets
27 Nov
For 19 months, I've been constantly attacked for advocating for elimination, and saying SARS-CoV-2 isn't a virus we can and should live with. It's been evolving in one direction from the start- greater transmissibility, escape & virulence. 🧵
But the hopium on 'benign endemicity' has been widespread- the idea that it'll magically become the common cold when all evidence has been pointing the other way for 19 months. Unfortunately, early signs don't look good.
So, I'll say this again. And trolls and my 'colleagues' can and will attack - but progressive coordinated and supported global elimination was the only way to really deal with this threat. And with every new variant, it gets harder to do this.
Read 10 tweets
27 Nov
61 people on a flight of 600to the Netherlands tested positive for COVID-19 on screening flights from SA - variant status now being assessed. Not imposing mandatory quarantine from all regions including SA is a huge failure of UK policy. This variant is very likely widespread.
Even if it's here (which I think it likely is), we need to slow spread- and we seem to be doing nothing in the face of what is a fast changing situation. Why? This is precious time for acting, and planning next steps, to protect the public in an evolving situation.
We need comprehensive mandatory border quarantines from all regions, mask mandates (high-grade masks), mitigations in schools (masks, ventilation, bubbles, quarantine for contacts), caps on large gatherings, and speed up of boosters, vaccines to kids.
Read 5 tweets
26 Nov
I know people will accuse me of 'fearmongering', but I'm really concerned by the potential threat posed by Nu: Why? TL;DR
-The rapid growth to dominance/near dominance in multiple parts of SA
-growth accompanied by increase in R
-accumulation of mutations - many of concern
Yesterday, we heard about the detailed work done on surveillance and characterisation of this new variant from SA. It has far more mutations compared to the original variant compared to delta. Many of these are shared with other VOCs, while many are new:
Many of the mutations are associated with escape at least in laboratory studies (although we don't have data on this particular variant with all its mutations yet). But early data suggests mutations associated with higher transmissibility & escape.
Read 23 tweets
25 Nov
The document that's being shared in this picture by @ALewerMBE is by @DrJBhattacharya an architect of the Great Barrington Declaration that advocated for 'herd immunity by infection'. Jay was disallowed as an expert witness in court due to misrepresentation of evidence on masks!!
Major flaws were highlighted in his testimony by multiple judges, with one concluding that he wasn't qualified to be an expert witness, and others suggesting his testimony was problematic. This is the person whose advice our govt ministers are sharing?
Read 4 tweets

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